Percutaneous techniques for the management of urological renal transplant complications

Percutaneous techniques were used to manage 13 renal transplant recipients with urological complications and long-term followup now is available. Three patients had urinary fistulas and 10 had ureteral obstruction. In 2 of the patients with ureteral fistulas and 5 with ureteral obstruction the percutaneous procedures provided definitive management and obviated the need for an open operation. In the 6 other patients the percutaneous procedures proved to be valuable adjuncts to subsequent planned open operative reconstruction. While there were 4 significant complications related to the percutaneous procedures, none resulted in graft loss or patient death. We conclude that percutaneous techniques provide valuable alternatives to immediate open operative intervention in renal transplant recipients with ureteral obstruction or fistula formation. Furthermore, these techniques may obviate entirely the need for subsequent operative intervention.