[Surgical treatment of urinary collections and obstructions in renal transplantation]

Collections after renal transplantation are represented by lymphoceles, hematomas and urinary leaks. Symptomatic lymphoceles should be treated by external puncture and drainage. Deeper lymphoceles and prolonged lymphorrhea must be surgically marsupialised, in association with epiploplasty. Acute hematoma in the area of transplantation requires surgical exploration and external drainage--this may induce a lymphorrhea. Urinary leaks and urinomas require drainage as well as an ureteral support. The leakage area determines whether surgery is necessary: be it reimplantation, psoïchal bladder or nature ureter. Intraluminal urinary obstructions responds to conventional urologic treatment. Distal parietal obstructions are surgically treated in the case of failure of percutaneous treatment by reimplantation, psoïchal bladder, native ureter, or even ureteroplasty or prosthesis. Stenoses extending over the entire ureter require surgical ureteral reconstruction. The treatment of extrinsic obstructions can be by ureteral drainage, uterolysis or ureteral reconstruction. In case of such complications, percutaneous techniques have reduced frequency and morbidity of open surgery.