Indications include recurrent Nephrolithiasis, Chronic flank pain refractory to medical management, Complex ureteral stricture disease. Preoperative considerations include that the procedure does not alter metabolic disease, denervation for pain symptoms increases risk of silent obstruction and finally, potentially leaves recurrent stone former with a functionally solitary kidney. However, reconstruction may complicate future stone-related procedures
In this presentation Dr. Duty summarized the experience from Oregan Health Sciences University. Total of 66 patients who underwent autotransplantation between April 1986 and April 2016 were included in the study. To note, this is the largest series of patients who underwent autotransplantation for nephrolithiasis. Mean age was 29 years old with the range 20 to 47 with the mean BMI of 26 (17-34). The length of stay was 5.3 days (4-7). Mean follow up on these patients was 21.5 months (5.6-48 months). There were 37.5% complications. No ancillary procedures were required.
Dr. Duty concluded that the renal autotransplant with vesicopyelostomy is a safe and effective technique for recurrent nephrolithiasis. It allows for a widely patent durable anastomosis and facilitates stone passage and endoscopy. Finally, it is associated with reduced number of stone-related procedures with no change in overall GFR and renal function.
Presented by Brian Duty, M.D. Department of Urology, Oregon Health Sciences University
Written By: Zhamshid Okhunov, MD, University of California, Irvine, USA, Department of Urology
34th World Congress of Endourology and SAUA meeting - November 7-12, 2016 – Cape Town, South Africa