[Antegrade fine needle pyelography of transplanted kidneys]

In a poorly functioning renal transplant ureteral obstruction or perforation must be considered as a cause. Sonography and radionuclide scanning may demonstrate outflow obstruction and/or pararenal fluid collection, but do not usually provide sufficient information on the site of the lesion. In these cases we have successfully used fine needle puncture of the renal pelvis under continuous sonographic guidance and antegrade pyelography. Successful puncture was always possible and exact details of the renal pelvis and ureter were provided after contrast injection. No complications were seen after fine needle puncture. Sonographic guidance is ideal in respect to practicability and cost effectiveness if compared to computed tomography scanning. The technique has proven to be simple and safe to perform. It provides a quick and valuable diagnosis and superior anatomical details for reconstructive surgery.