TREATMENT OF TRANSPLANT URETERAL STENOSIS WITH ACUCISE ENDOURETEROTOMY

Treatment of ureteral stenosis has been attempted in many patients wit h transplanted kidneys. Treatment with the Acucise catheter system is a new approach for such patients. Published results of the approach in eight patients promise safety, effectiveness, and low perioperative m orbidity. We report two cases of transplant ureteral stenosis treated with Acucise. One patient with stenosis of the pyeloureteral junction was treated successfully and has been free of recurrence for 9 months. The other patient had long-distance stenosis of the lower portion of the transplant ureter. Acucise incision was successful, but the patien t had to undergo ureteroneocystostomy because of a ureteroperitoneal f istula. We use these cases to illustrate the disadvantages of endourol ogical ureteral surgery as a standard therapeutic approach after renal transplantation. We suggest that Acucise is reliable when used in pat ients with uncomplicated short-distance ureteral stenosis; however, pa tients with long-distance stenosis or stenosis caused by heavily scan ed periureteral tissue will not profit from it because of a higher com plication rate.