Urology Resident City of Hope National Medical Center
Introduction: Kidney transplantation is a widely performed procedure for patients with end stage renal disease. Urologic complications from the transplant kidney range from 3-30% with the incidence of ureteral stricture ranging from 1.9-3.7%. Of all complications that require surgical intervention, ureteral stricture accounts for 78% of them. We aim to discuss the technical considerations and present our outcomes after robotic anastomotic stricture revision in the transplanted kidney.
Methods: We retrospectively reviewed five patients who underwent open kidney transplantation with donor kidney who subsequently developed ureteral stricture and were treated with robotic repair with a single surgeon. All patients were confirmed to have ureteral stricture with preoperative antegrade nephrostogram.
Results: The average age of the patients was 54.4 years. 3 patients required ureteroureterostomy to native ureter, 1 required ureteroneocystostomy, and 1 required boari flap. The mean length of stay was 2 days. Average follow up was 326 days with no leaks identified. There were no wound infections or readmissions within 30 days. We had a 100% success rate in our cohort.
Conclusions: By using an algorithmic approach with standardized evaluation, robotic repair of ureteral stricture in a transplant kidney can be done safely and effectively.