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Endoscopic management of urologic complications following renal transplantation: impact of ureteral anastomosis.

Abstract：

OBJECTIVE:To evaluate the success of ureteral stent placement to treat or prepare for surgical treatment of urologic complications after renal transplantation, according to a type of ureteral anastomosis. PATIENT AND METHODS:From May 1989 to December 2006, we performed 703 kidney transplantations including 412 extravesical ureteroneocystostomy (according to Lich-Gregoire technique) and 265 transvesical ureteroneocystostomy (according to Politano-Leadbetter technique). We retrospectively analyzed our endoscopic management of urinary leaks and ureteral strictures. The criteria of success were the feasibility to place a ureteral stent, permitting good drainage of the upper renal graft tract before further endoscopic or surgical treatment. RESULTS:Forty-three urinary leaks or ureteral strictures occurred after extravesical ureteroneocystostomy (n = 21) or after Politano-Leadbetter anastomosis (n = 22). The success rate of endoscopic management was 75% (n = 16) for Politano-Leadbetter anastomosis versus 53% (n = 11) for the Lich-Gregoire anastomosis. There was no statistical difference (P = .1). CONCLUSION:Ureteroneocystostomy according to Lich-Gregoire procedure were twice less complicated than those according to the Politano-Leadbetter technique, but were associated with a rate of failure of ureteral stent placement in urgency higher to 25%.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Tillou X,Raynal G,Demailly M,Hakami F,Saint F,Petit J

doi

10.1016/j.transproceed.2009.08.046

subject

Has Abstract

pub_date

2009-10-01 00:00:00

pages

3317-9

issue

8

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(09)01239-1

journal_volume

41

pub_type

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