Short or Absent Native Ureter?

Ron Shapiro, MD

December 02, 2003

Question

What do you do in the case of a short ureter or absence of a native ureter in kidney transplantation?

Manuel Melo y Escalante, MD

Response from Ron Shapiro, MD

This is really 2 or 3 different questions. In the case of a short donor ureter, it is relatively straightforward to anastomose the transplant ureter to the native ureter, either end-to-side or end-to-end; we routinely stent these anastomoses for 6 weeks. Occasionally, it may be necessary to remove the native kidney if one is performing an end-to-end reconstruction; but, in fact, it is generally agreed that this is usually not necessary, and in my experience, this has been the case.

If the transplant ureter is normal and the native ureter is not present, a standard ureteroneocystostomy would be sufficient. In the unusual circumstance where the transplant ureter is short and the native ureter is not present (I am not actually sure that I have ever seen this, to be honest), one could use the contralateral native ureter, or one could construct a Boari flap using the bladder.

Cite this: Ron Shapiro. Short or Absent Native Ureter? - Medscape - Dec 02, 2003.

Comments

Commenting is limited to medical professionals. To comment please Log-in.

Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.