J Korean Soc Transplant.  2004 Dec;18(2):179-182.

Ureteroureterostomy after Ureteroneocystostomy Complications in Renal Transplantation

• Ku BI
• Kim SW

Abstract

PURPOSE
At present renal transplantation, the most frequent surgical complications may be occurred on ureterovesical anastomosis site (i.e. leakage, stenosis and reflux). The results of ureteroureterostomy using recipient's own ureter in these complications, will be presented.
METHODS
From 1983 to 2004, 410 renal transplantations were performed at our institution. In all cases, external ureteroneocystostomy technique was used. Complications involving the anastomosis site occurred in 23 cases (5.4%), with 15 stenosis (3.4%) and 8 cases of leakage (1.9%). All of them were living donor cases. The mean recipient's age was 47.2 years. Corrective surgery were performed as soon as complication confirmed radiologically (ultrasonography), 16.1+/-22.3 days after transplantaion for leakage and 86.8+/-87.6 days for stenosis. If the length of graft ureter was long enough, ureteroneocys tostomy was performed again and if not, end to side ureteroureterostomy was performed in 12 cases, end to end ureteroureterostomy in 1 case and end to end pyeloureterostomy in one case. A double J ureteral stent was used in every case.
RESULTS
There were one graft loss due to stone formation nephropathy, one mortality due to herpetic infection with functioning graft and one failure of recovery of graft function because of too late patients visit. Others had good graft function until last follow up with 3.8+/-2.5years of mean follow-up without further ureteral complications.
CONCLUSION
Ureteroureterostomy is a safe and permanent treatment for complications of ureterovesical anastomosis site and gives good results.

Keyword

Ureteroureterostomy; Leakage; Stenosis

MeSH Terms

Constriction, Pathologic
Follow-Up Studies
Humans
Kidney Transplantation*
Living Donors
Mortality
Stents
Transplants
Ureter