Progressive development of endourological procedures has revolutionized the management of urolithiasis in transplanted kidneys. In this article we report our experience in endourological procedures for treatment of calculi in transplanted kidneys. Between 1989 and 2008, 1300 renal transplantation were performed in our center. 18 cases (14 adults and 4 children) with calculi (6 pelvic and 12 ureteral stone) were treated by ESWL , TULP and PCNL. We follow up the patients by ultrasonography every 3 months for 2 years and then once yearly. Incidence of calculi in transplanted kidney in our center is 1.3%. Kidney stone size varied between 12 – 18 mm and in ureteral 6 – 10 mm. Success rate of becoming stone free by ESWL was 75% (4/6) by PCNL 100% (3/3) and TUL 80% (8/10). 3 patients require several modalities for treatment , in these patients at first we performed TUL and pushed the stone into the pelvic and then performed ESWL. Two of them did not respond to this treatment so they were treated by PCNL. At a mean range follow up of 58 months all cases were stone free. 3 cases lost their graft due to chronic rejection but in 15 cases renal function was good and no recurrence of urinary calculi was reported. In conclusion, although urinary tract calculi in transplanted kidney are rare but must be considered in follow up of recipients. Endourological procedures for treatment of calculi in transplanted kidney are safe and effective and preclude the need of open surgery.
Volume : 6
Issue : 4
Pages : 209
Urological and Renal transplantation Department, Imam Reza Hospital, Mashad University of Medical Sciences, Mashad, Iran