Ileo-pelvic anastomosis and augmentation cystoplasty for treatment of encrusted pyelitis in a transplanted kidney

Korean J Urol. 2013 Feb;54(2):143-6. doi: 10.4111/kju.2013.54.2.143. Epub 2013 Feb 18.

Abstract

Infection stones are more likely to form after urinary diversion as the result of urinary stasis. To prevent urinary stasis due to encrusted pyelitis in a transplanted kidney, we describe an alternative a surgical treatment: ileo-pelvic anastomosis. In our patient with a transplanted kidney, the ileal conduit had previously been anastomosed end-to-side owing to renal tuberculosis with an atrophied bladder; the transplanted ureter was anastomosed to the ileum in the left lower abdomen with an ileal conduit on the opposite side. Routine check-up revealed hydronephrosis with infected pyelitis and ureteritis in the transplanted kidney. We performed ileo-pelvic end-to-end anastomosis to prevent urinary stasis by lengthening the ileal conduit and performed augmentation cystoplasty to support the atrophied bladder following tuberculosis. We suggest that this approach may be useful in similar cases.

Keywords: Kidney transplantation; Pyelitis; Urinary diversion.