V02-09 LAPAROSCOPIC PYELO-URETEROSTOMY OF GRAFT KIDNEY TO NATIVE URETER FOR A POST TRANPLANT RECURRENT URETERAL STRICTURE

Abstract

You have accessJournal of UrologyBPH, Male Voiding Dysfunction, and Transplantation1 Apr 2018V02-09 LAPAROSCOPIC PYELO-URETEROSTOMY OF GRAFT KIDNEY TO NATIVE URETER FOR A POST TRANPLANT RECURRENT URETERAL STRICTURE Jitendra Jagtap, Lokesh Sinha, Vinayak Kore, Vikash Kumar, Sachin Veer, and Pradeep Rao Jitendra JagtapJitendra Jagtap More articles by this author , Lokesh SinhaLokesh Sinha More articles by this author , Vinayak KoreVinayak Kore More articles by this author , Vikash KumarVikash Kumar More articles by this author , Sachin VeerSachin Veer More articles by this author , and Pradeep RaoPradeep Rao More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.468AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Complicated recurrent ureteral strictures post renal transplantation have traditionally been managed by standard open surgical technique. We describe a successfully performed laparoscopic pyelo-ureterostomy between the graft kidney and native ureter for a long segment recurrent distal ureteral stricture in a 40 year old female. METHODS The patient had undergone a living related renal transplantation 3.5 years ago. She developed a distal ureteral stricture 3 years later and underwent an antegrade placement of a nephroureteral stent after balloon dilatation of the stricture. A month later she required an exploration, excision of distal ureteral strictured segment and ureteroneocystostomy for obstructive uropathy. Four months later she again presented with oliguria, rising creatinine and moderate hydroureteronephrosis. This time a laparoscopic pyelo-ureterostomy was performed using conventional three ports (two 10mm and one 5mm) triangulated towards the graft kidney. Intraoperative use of a 12MHz drop-in ultrasound probe aided in identification of the dilated graft pelvis and preoperative ureteral catheterisation helped in identification of right native ureter. Spatulated tension free anastomosis was performed with Polyglactin 4-0 sutures. RESULTS Operative time was 112 min with no intra operative complication. Postoperative course was uneventful. Hemoglobin drop was 0.2 gm/dL. Drain and catheter were removed on third postoperative day. Postoperative hospital stay was four days. Ultrasound on discharge showed resolution of the hydroureteronephrosis. DJ stent was removed after 15 days of surgery. CONCLUSIONS Laparoscopic pyelo-ureterostomy is a safe and efficacious technique for management of complicated recurrent ureteral strictures post renal transplantation. It additionally offers better comesis and shorter convalescence. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e169 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jitendra Jagtap More articles by this author Lokesh Sinha More articles by this author Vinayak Kore More articles by this author Vikash Kumar More articles by this author Sachin Veer More articles by this author Pradeep Rao More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...