Percutaneous nephropyelostomy in the management of obstructed renal transplants.

Five percutaneous nephropyelostomies were performed on 4 patients with obstructed renal allografts. In all instances the procedure significantly influenced further management of these patients. It allowed pressure measurement within the obstructed collecting system, assessment of renal function after prolonged drainage, and anatomical delineation of the site of the obstruction using antegrade pyelography. Percutaneous pyelonephrostomy and drainage is a useful means to determine whether obstruction or rejection is the major contributor to renal failure following renal transplantation.