Department of Urology, Saint Louis Hospital , Paris, France.
J Endourol. 2011 Aug;25(8):1389-92. doi: 10.1089/end.2011.0085. Epub 2011 Jul 20.
Extended ureteral stricture is a rare complication of renal transplantation. Its management remains challenging. The aim of our study was to report our 15 years of experience with subcutaneous pyelovesical bypass graft (SPBG) in selected renal transplant patients who presented with extended ureteral stricture and who were not eligible for open ureteral reconstruction.
Seven patients were operated on between 1992 and 2007-six men and one woman-with a mean age at surgery of 47 years (range 30-67 y).
We report no encrustation or dislodgment with a mean follow-up of 6 years (range 1-14 y). Postoperative mortality was null. During the follow-up, three patients died: Two from an extrarenal cause with a functional SPBG and a stable renal function; one from septic shock after fungic colonization of the prosthesis. Asymptomatic urinary tract infection developed in two other patients, with no renal function impairment.
Despite a 47% rate of infection (3/7), SPBG can be a safe and efficient alternative to open surgery to save many years of graft function in renal transplant patients who present with extended ureteral stricture.
移植肾输尿管狭窄是肾移植术后少见的并发症，处理起来有一定难度。我们旨在报告 15 年来，对 7 例不适合开放手术的移植肾输尿管长段狭窄患者，行经皮穿刺肾盂-膀胱皮下旁路转流术（SPBG）的经验。
1992 年至 2007 年间，我们对 6 例男性和 1 例女性患者施行手术，平均年龄 47 岁（30-67 岁）。
我们报告无结石形成或移位，平均随访 6 年（1-14 年）。术后无死亡病例。随访期间 3 例患者死亡：2 例因肾外原因，SPBG 功能良好，肾功能稳定；1 例因假体真菌定植后发生感染性休克。另外 2 例患者发生无症状性尿路感染，肾功能无损害。
尽管感染率为 47%（3/7），但对于移植肾输尿管长段狭窄患者，SPBG 是一种安全有效的手术替代方法，可以保留许多年的移植物功能。
