Flexible cystoscopy and retrograde catheterization in renal transplant patients

Catheterizing the ureteral orifice of a renal transplant patient can be difficult using traditional rigid instruments. This report describes our experience with 4 patients who underwent cystoscopy and attempted retrograde catheterization of a transplanted ureter. In all cases attempted catheterization using rigid instruments was unsuccessful, while in 3 of the 4 patients, successful cannulation was accomplished using the flexible cystoscope. These results are attributed to the expanded range of motion achieved with the tip of the flexible cystoscope. The increased mobility afforded by this instrument facilitates access to the ureteral orifice, which is often positioned on the distensible portion of the bladder.