Ureterocalicostomy Using Native Ureter in an Allograft Kidney: A Case Report

Area of Science:

• Nephrology
• Urology
• Transplant Surgery

Background:

• Ureteral obstruction is the most frequent complication following renal transplantation.
• Management typically involves minimally invasive or open surgical interventions.
• Extensive ureteral strictures pose significant challenges in post-transplant care.

Observation:

• This report details a ureterocalicostomy combined with lower pole nephrectomy for a renal transplant patient with a severe ureteral stricture.
• Literature review identified only four previous cases of ureterocalicostomy in allograft kidneys.
• Among these, just one case incorporated a partial nephrectomy, highlighting the rarity of this combined approach.

Findings:

• The procedure involved creating a direct connection between the ureter and the renal calyx.
• Lower pole nephrectomy was performed to address specific anatomical challenges.
• Successful clinical outcomes were achieved in this patient with extensive ureteral stricture and a contracted intrarenal pelvis.

Implications:

• Ureterocalicostomy with lower pole nephrectomy represents a viable, albeit rarely applied, surgical option.
• This technique is particularly suitable for complex cases of allograft ureteral stricture.
• It offers a potential solution for patients with small, contracted, and intrarenal pelves where standard reconstructive methods may fail.