Pieloureterostomía a uréter nativo en un paciente con trasplante renal y estrechez ureterovesical complicada con urolitiasis múltiple y falla renal aguda. Colombia

Abstract

Renal Transplant (RT) is currently considered as the standard treatment in End Stage Renal Failure patients. There are descriptions in the literature of the many early or late complications that can occur after the surgery has been performed, such as ureteral stenosis, uretero-vesical implant stenosis, urinary tract infections, and urinary stones. PurposeTo present a case of A 51 year-old male with a living donor renal transplant who developed acute renal failure with hydroureteronephrosis, and multiple urinary stones. Materials, methods and results: The case is presented of 51 year-old male, receiver of a living donor renal transplant, who after 10 years after the transplant developed acute renal failure, with anuria, and impaired renal function tests. Hydronephrosis was detected by ultrasound, and multiple renal and ureteral stones, and ureteral dilatation were observed in the CT scan. He was initially treated with percutaneous nephrostomy, and after clinical improvement an unsuccessful antegrade and retrograde endoscopic approach was attempted. Then, in order to avoid the risk of losing the graft, an open procedure was performed by pyeloureterostomy (from transplanted kidney pelvis to native right ureter), a resection of the stenosed ureter, and extraction of urinary stones, with graft recovery. ConclusionsMany urological and non-urological complications have been described in patients with renal transplant. A case of a patient with multiple complications and acute renal failure, hydronephrosis, urinary stones and risk of losing the graft is described here. Renal function recovered after treatment was performed.© 2013 Sociedad Colombiana de Urología. Published by Elsevier España, S.L. All rights reserved.