Endourological treatment of symptomatic ureteral stump posnephrectomy. / Tratamiento endourológico del muñón ureteral sintomático posnefrectomía.

INTRODUCTION: ureteral stump syndrome is defined as a recurrent urinary infection, low abdominal pain and haematuria in patients with a history of nephrectomy. Its incidence is low and the symptoms are non-specific. The aim of our paper was to present our results with endoscopic treatment of symptomatic ureteral remnants. MATERIAL AND METHODS: We performed a retrospective study of patients with ureteral remnant syndrome after nephrectomy treated in our centre between 2004 and 2015. We present a series of 10 patients. The patients were treated endoscopically with electrofulguration of the ureter and edges of the affected meatus, with subsequent injection of filler material into the suburetheral submucosa to aid in the coaptation of the ureteral remnant walls. RESULTS: The mean age at treatment was 2 years. The right ureteral remnant was treated in 6 patients and the left in 4. Seven meatuses were ectopic and 3 orthotopic. Follow-up was 8 years. After endoscopic treatment only 2patients relapsed. CONCLUSION: Endourological treatment of ureteral stump syndrome is a simple, safe, rapid and effective option that can be performed as an outpatient, for orthotopic and ectopic stumps. It does not compromise subsequent open resection of the ureteral remnant if required, and therefore we believe that it should be considered a valid alternative for the initial treatment of this disorder.

Tratamiento endoscópico de estenosis ureteral en paciente con trasplante renal / Endoscopic management of ureteral stenosis in a transplanted kidney

Las complicaciones post trasplante han disminuido gracias a la mejor inmunosupresión y las técnicas quirúrgicas más desarrolladas, pese a ello, la estenosis de la unión ureterovesical se mantiene como una frecuente causa de morbilidad (2 por ciento al 10 por ciento), representando el 70 por ciento de las complicaciones urológicas. El tratamiento mínimamente invasivo endourológico es una opción válida con muy buenos resultados e índices bajos de complicaciones. Presentamos un caso clínico de estenosis ureteral en un paciente trasplantado y describimos su resolución a través de una técnica endourológica anterógrada.

Secondary to a better immunosuppression and surgical techniques post-transplant complications have decreased, however the ureterovesical junction stricture remains a frequent cause of morbidity (2 to 10 percent), representing the 70 percent of urologic complications. The minimally invasive endourological treatment is an alternative treatment with very good results and low complications rates. We present a case of neovesical junction stricture in a transplant patient and describe its resolution through an anterógrada endourological technique.