Early hydronephrosis following aortic bifurcation graft surgery: a prospective study

The true incidence and natural history of ureteral obstruction following reconstructive vascular surgery have not been determined previously. A series of 101 patients undergoing aortofemoral and aortoiliac reconstructive surgery were studied prospectively to determine the frequency of hydronephrosis in the first postoperative year. Serial real-time ultrasound examinations were performed preoperatively as well as at 1 week, 3 months and 1 year postoperatively. Ninety-three patients completed the study, with a total of 181 kidneys at risk. Hydronephrosis of mild to moderate degree developed in 15 kidneys (8 per cent) in 11 patients (12 per cent). All patients were asymptomatic, and the obstruction resolved spontaneously in 10 of 11 patients, including 9 within 3 months of onset. Only a single case persisted at 1 year. This study confirms that the hydronephrosis that occurs within the first year after aortic bifurcation graft surgery is not uncommon but it is rarely of clinical significance in the asymptomatic patient.