Subcutaneous nephrovesical bypass in kidney transplanted patients

Area of Science:

• Urology
• Transplant Surgery
• Medical Devices

Background:

• Renal transplant ureteral stricture/obstruction is a rare but severe complication.
• Recurrent ureteral obstruction poses significant challenges in kidney transplant recipients.

Purpose of the Study:

• To evaluate the efficacy and safety of subcutaneous prosthetic ureters.
• To assess this salvage procedure for transplanted kidneys with recurrent ureteral obstruction.

Main Methods:

• Five patients with recurrent ureteral stenosis underwent implantation of subcutaneous prosthetic ureters.
• The prosthetic ureter involved a silicone tube within a PTFE coil, placed via a subcutaneous tunnel.
• The procedure included percutaneous insertion into the kidney and suprapubic insertion into the bladder.

Main Results:

• Mean follow-up was 11.3 months.
• One patient required reoperation for distal urinary leakage.
• No instances of infection or tube encrustation were observed.

Conclusions:

• Subcutaneous prosthetic ureters provide a viable alternative to permanent percutaneous nephrostomy.
• This method is effective for transplanted kidneys with ureteral obstruction unresponsive to prior interventions.