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Ureteroscopy for nephrolithiasis in transplanted kidneys.

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Retrograde ureteroscopy (URS) is a viable treatment for small kidney stones in transplant patients. This study shows URS can lead to stone clearance and outpatient treatment, often avoiding percutaneous nephrolithotomy (PCNL).

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Area of Science:

  • Nephrology
  • Urology
  • Transplant Surgery

Background:

  • Percutaneous nephrolithotomy (PCNL) is standard for transplant kidney stones.
  • Retrograde ureteroscopy (URS) is an alternative for small stone burdens.

Purpose of the Study:

  • To evaluate the efficacy and safety of retrograde URS for renal and ureteral calculi in transplant kidneys.
  • To report the largest single institutional series of URS in this patient population.

Main Methods:

  • Retrospective review of nine retrograde URS procedures in seven transplant patients.
  • Procedures performed by two endourologists between June 2009 and September 2013.

Main Results:

  • Successful endoscopic stone treatment in seven of nine procedures.
  • Stone-free status achieved in five of seven treated cases.
  • Two postoperative urinary tract infections, no major complications; most patients treated as outpatients.

Conclusions:

  • Retrograde URS with laser lithotripsy and/or basket extraction is a reasonable option for small renal transplant stones.
  • This approach facilitates outpatient management and complete stone clearance, potentially avoiding PCNL.