Acute presentation of ureteral stump empyema after pretransplant
nephrectomy has not been reported so far. We
report on a 25-year-old male patient with end-stage renal
disease due to congenital vesicoureteral reflux and a longterm
history of management of infected kidneys including
the last step of pretransplant right native nephrectomy.
Within 2 weeks after operation, he presented with clinically
visible ureteral stump empyema. Computed tomography
and surgical exploration confirmed the diagnosis of a huge
retentive stump of obstructive-refluxing megaureter which
was excised with a smooth postoperative course. So, ureteral
stump empyema may develop after a pretransplant nephrectomy
and threaten the transplant process and the patient’s
life. Consecutive nephrectomy and ureterectomy procedures
to keep the iliac fossa fresh for kidney transplantation
do not outweigh the risks of ureteral stump infections.
Therefore, simultaneous nephroureterectomy is mandatory
in the case of obstructive-refluxing megaureter.