Korean J Urol.  2013 Feb;54(2):143-146.

Ileo-Pelvic Anastomosis and Augmentation Cystoplasty for Treatment of Encrusted Pyelitis in a Transplanted Kidney

• Chin C
• Chung JS
• Oh CK
• Kim SC
• Hong SW
• Park SH

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.

Keyword

Kidney transplantation; Pyelitis; Urinary diversion

MeSH Terms

Abdomen
Humans
Hydronephrosis
Ileum
Kidney
Kidney Transplantation
Pyelitis
Transplants
Tuberculosis
Tuberculosis, Renal
Ureter
Urinary Bladder
Urinary Diversion

Figure

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  FIG. 1 Preoperative ultrasonography revealed multiple infection stones with hydronephrosis in left transplanted kidney.

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  FIG. 2 Abdominopelvic computed tomography revealed hydronephrosis with encrusted pyelitis and ureteritis in transplanted kidney.

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  FIG. 3 Postoperative ultrasonography scan showing that calcified debris was decreased, encrusted pyelitis was absent, and hydronephrosis was improved.

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  FIG. 4 Postopearative cystogram shows no leakage and remnant ileum with the transplanted kidney anastomosed with augmented bladder. Bladder capacity is increased from 50 to 300 mL, a capacity near the normal limit.

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  FIG. 5 (A) Fifty-one-year-old female patient had renal tuberculosis 12 years before. (B) The patient had double nephrectomy with transplanted ureter was anstomosed ileum end to side. (C) Routine check-up revealed hydronephrosis with infected pyelitis and ureteritis in transplanted kidney. (D) We performed ileo-pelvic end-to end anastomosis to prevent urinary stasis by lengthening ileal conduit, and performed augmentation cystoplasty to support the atrophied bladder following tuberculosis.

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