Obstructive uropathy in the transplanted kidney: Definitive management with Percutaneous nephrostomy and prolonged ureteral stenting

Background and Purpose: Renal transplantation is an effective treatment for end-stage renal disease. Ureteral stenosis is the most frequent urologic complication. We report our experience with percutaneous nephrostomy and antegrade ureteral stenting, which may offer a primary and definitive alternative to open surgery. Patients and Methods: Fifteen patients with renal allograft obstructive uropathy were managed with percutaneous nephrostomy and prolonged ureteral stenting. Results: Percutaneous nephrostomies were successfully performed in all 15 kidneys: In 13 patients, antegrade ureteral stenting was attempted, this being successful in 11 (85%). After prolonged ureteral stenting (mean duration 15 months), the stent was removed in eight patients, and six of them (75%) did not have recurrences. During follow-up, urea, creatinine, sodium, and potassium determinations and ultrasound scans were performed, and success was confirmed by the decline of creatinine and reduction in hydronephrosis. No major complica...