Extra-anatomic stent (EAS) as a salvage procedure for transplant ureteric stricture

Abstract

Ureteric stricture is the most common urological complication following renal transplantation. Management often involves endo-urological interventions and open surgery. The definitive treatment is surgical reconstruction to restore continuity. Where this is not possible or contra-indicated and a stent cannot be placed in the ureter, an extra-anatomic stent (EAS) could be used to bypass a complete ureteric obstruction. Using an existing nephrostomy tract, a percutaneous stent is placed in the kidney and is tunneled under the skin into the bladder establishing extra-anatomical urinary drainage. We report the use of a novel EAS system in a patient with transplant ureteric stricture when antegrade stent placement or surgical reconstruction was not possible. The authors describe the insertion of a novel extra-anatomic stent in a 65-year-old male renal transplant patient in whom all conventional methods of treatment (endo-urological and surgical) failed to bypass a complete ureteric obstruction. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.