A 4-year review of balloon dilation of ureteral strictures in renal allografts

Background: Ureteral obstruction necessitating intervention occurs in 2% to 7.5% of all renal allograft recipients. Conventional management includes open surgical repair, although more recently, percutaneous ureteral dilation has been performed. Patients and Methods: The management and outcome of all seven allograft ureteral strictures treated with balloon dilation in our unit over a 4-year period were reviewed. Half (55%) of these strictures occurred in the proximal ureter. Results: Four strictures were dilated successfully with a requirement for five dilations in total. These patients have stable graft function with no evidence of obstruction. Five strictures persisted despite 11 dilations. There were no significant complications from balloon dilation. Conclusion: Definitive surgical management should be considered if obstruction persists after one attempt at ureteral dilation, as multiple dilations have a low success rate (25%).