[The treatment of urinary fistula in renal transplantation]

61 renal transplant patients developed a urinary fistula (4%). The diagnosis was established rapidly (after an average of 12 days) by the presence of urine in the drains and a urine collection on ultrasonography. The exact topographical diagnosis, the nature of the fistula, necrosis or dehiscence, is more difficult, even with modern imaging techniques. The incidence of fistula was decreased by the use of a short ureter, a Lich-Grégoir ureterovesical anastomosis and the prophylactic insertion of a ureterovesical stent. The first 36 ureteric fistulae were treated by open surgery and the last 7 were treated by antegrade stent insertion. 87% of patients were cured of their fistula and retained their transplant: 31 of the 36 patients undergoing open surgery and all 7 patients treated percutaneously. Percutaneous treatment should be proposed as first-line treatment in the case of ureteric fistula after renal transplantation.