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[Treatment of complex fistula and urinary stenosis in renal transplantation]
L Crespo Martínez1, E Fernández Fernández, J Burgos Revilla
1Servicio de Urología, Hospital Ramón y Cajal, Madrid, España.
Objectives:
Urological complications in renal transplantation occasionally denote the failure of a technique intended to provide the patient on hemodialysis a significant improvement of quality of life. Our experience in the management of these complicated cases which could not be resolved by conventional measures is described.
Methods:
Since the transplantation program began, our department has performed 530 renal transplants. There have been 40 fistulae (7.5%) and 23 stenoses (4.3%) of graft urinary tract. All the foregoing complications had been treated by endourological procedures (nephrostomy or ureteral stent) and/or simple ureteral reinsertion. There were 5 unresolved or recurrent fistulae (0.9%) and 2 stenoses (0.4%) that were repaired using the recipient's ipsilateral urinary tract (6 pyeloureterostomies and 1 pyelopyelostomy).
Results:
Good results were achieved in all of the cases with adequate urinary tract function.
Conclusions:
Urological complications following renal transplantation can be successfully treated by surgical correction (pyeloureterostomy or pyelopyelostomy).