URETERAL OBSTRUCTIONS AND LEAKS AFTER RENAL-TRANSPLANTATION - OUTCOMEOF PERCUTANEOUS ANTEGRADE URETERAL STENT PLACEMENT IN 44 PATIENTS

PURPOSE: To analyze the outcome of percutaneous antegrade ureteral ste nt placement for treatment of ureteral stenoses and leaks after renal transplantation.MATERIALS AND METHODS: Antegrade pyelography and percu taneous ureteral stent placement were performed in 45 patients with ur eteral obstruction (n = 40), leak (n = 3), or both (n = 2). Obstructio ns were graded as mild, moderate, or complete, and as early (less than or equal to 3 months after transplantation) or late (>3 months). RESU LTS: The outcome of stent, placement was successful in 25 (57%) patien ts (average follow-up, 30 months). The ureteroneocystostomy (UNC) was the most common site of obstructions (22 of 41), leaks (four of five), and successful outcomes (16 of 22). Moderate obstructions were most c ommon (29 of 41) and responded best to treatment (17 of 29). Eighteen (69%) of 26 early obstruction sand five (33) of 15 late obstructions w ere successfully managed percutaneously. All complications (12 of 45 p atients) were minor, with infections the most common (n = 7). No morta lity or allograft loss was attributable to stent placement. CONCLUSION S: Ureteral stents are safe and effective for the treatment of obstruc tions and leaks and are particularly effective for early and UNC obstr uctions. These stents may also be useful for temporary drainage.