Evaluation of the therapeutic efficacy of percutaneous nephropyelostomy for hydronephrosis after renal transplantation

Objective: To explore the method of percutaneous nephrostomy and the cause with prevention and treatment of the complication. Methods: 16 patients with nephrohydrosis after kidney transplantation in right iliac fossa were taken percutaneous nerphrostomy with coaxial puncture technique under ultrasound and fluoroscopic guidance; and by different operation methods according to the patient's condition. The color and volume of urine were observed, urine routine and renal function were rechecked after the operation. Results: The pyelography showed that all 16 patients had different degree nephrohydrosis and ureteral obstruction; including 7 ureteral complete obstructions and 9 ureteral incomplete obstructions. 3 cases received percutaneous pelvic external drainage and 13 others received percutaneous antegrade endoluminal balloon dilation of ureterostenosis and drainage. The average levels of serum urea nitrogen and creatinine decreased from 28.3 mmol/L and 537.7 μmol/L before operation to 9.7 mmol/L and 148.6 μmol/L one week after the operation respectively. Nephrohydrosis disappeared under ultrasonic inspection after the operation and no nephrohydrosis occurred in all patients during follow up of 4 to 48 months except one of double J catheter inadequate drainage two months postoperatively and in turn received external drainage. Conclusions: Characterized with simple manipulation, less invasion and complications, interventional therapy is a reliable and effective for repal transplanted patients with nephrohydrosis.