#0075

A 33 yrs old male patient 9 months post RAR presented with increasing creatinine lower ureteric stricture n proximal ureteric diverticulum,managed with Pyelo native ureterostomy

D. Sadasukhi¹, D. Shah², D. Varanwal²

¹MGH, Renal transplant n urology, Jaipur, India
²MGH, Urology, Jaipur, India

Introduction:

A 33yrs male patient underwent Renal allogenic Recipient surgery 9 months back,he was fine 2 months back when his creatinine suddenly started showing a increasing trend on USG graft kidney showed hDN,pt had undergone renal transplant 7 yrs bak graft was placed in rt iliac area that time wich eventually went in rejection.

Material and methods:

Second time graft was placed on left side n due to increasing creatinine trend MR Pyelogram was done,wich showd lower ureteric narrowing with stricture n a proximal ureteric diverticulum.

Results:

So re exploration n uretero native ureterostomy was planned,after opening wound in same layers reached to graft ureter traced upwards,a diverticulum was seen arising from upper part of transplanted ureter,wich was excised n ureter was opened longitudinally upwards,native left ureter was identified after retracting peritoneum as high as possible,after lighting upper most part,native ureter was ligated n cut n split longitudinally for ABT 2 cms n end to side uretero native ureterostomy was done over a 5 by 26 Fr DJ stent, abdominal drain 28 was put wound closed in layers.