2013 Volume 1 Issue 1 Pages 61-68
Objective : We discuss our experience of treatment for nephroureterolithiasis in allograft kidney and ureter, after kidney transplantation. Case 1 is 64 year-old male who underwent oversea deceased kidney transplantation at People’s Republic China on December, 2006. After came back to Japan, he suffered from renal allograft ureteropelvic junction (UPJ) stenosis. We anastomosed allograft renal pelvis with his native right ureter. During operation, indwelling the ureter stent was placed. After ureter stenting, we could not remove the ureter stent due to stone formation which located in UPJ and attached to ureter stent. 1st percutaneous nephrolithotomy (PNL) was performed on May, 2008. The stone was partially broken and the ureter stent was removed. The cause of stone formation was secondary hyperparathyroidaidation, and selective parathyroidectomy was performed on July, 2008. The stone was broken totally after total four session of PNL. Case 2 is 66 year-old male who underwent oversea deceased kidney transplantation at People’s Republic China on July, 2004. He suffered from anuria with complete allograft ureter obstruction due to allograft ureter stone on January, 2011. After ureter stenting, we performed 1st flexible transurethral ureterolithotripsy (f-TUL) using flexible ureteroscope and holmium yttrium-aluminum-garnet (Ho-YAG) laser, on October, 2011. The stone was broken totally after total three session of f-TUL. Conclusions : We could broke allograft kidney and ureter stones by treatment PNL and f-TUL. New devices such as flexible ureteroscope and Ho-YAG laser might be useful for the treatment for nephroureterolithiasis in allograft kidney and ureter after kidney transplantation.
