Value of percutaneous diagnosis and therapeutic procedures in obstructive uropathy following kidney transplantation

Postrenal obstruction is a severe complication after renal transplant. To evaluate side effects and effectiveness we analyzed 71 ategrade pyeloureterographies (AP) and 30 percutaneous and open nephropyelostomies. AP shows a sensitivity of 93% and proved thereby its superiority to alternative diagnostic procedures. Also percutaneous pyelostomy proved its reliability in therapy of obstructive disease. Comparing side effects to those in normal kidneys we found a higher incidence of bleeding (17%). There was no severe complication with loss of graft. In 6 cases of obstructive disease we could prevent an operation by temporary percutaneous nephrostomy. Long term nephrostomy allows to evaluate the function of the kidney accurately which may not be possible until after 1-2 months.