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Volume: 2 Issue: 2 December 2004 - Supplement - 1

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SURGICAL TECHNIQUES IN TREATMENT OF UROLOGIC

Urologic complications are one of the most common complications after renal transplantation. Early diagnosis and suitable treatment can preserve function of transplantated kidney. In this study incidence of urologic complications, surgical techniques and results of treatment were evaluated. During 1989-2002, 700 renal transplantations have been performed in our center. 200 of them were followed for an average of 4 years (1-13years). Urologic complications were considered at patients with creatinine level rising without signs of renal rejection. Follow up evaluation methods were included: serum creatinine level, Reno vesical ultrasonography, Radioisotope scanning, Nephrostomograme. Results from 200 cases, 14 cases had complications (7%) Mean age of patients was 29 y (11-48) and complications occurred between 12th and 950th days (mean 147 d) after transplantation. Patients had received graft from living unrelated (9 cases), living related (1 cases), and cadaver (4 cases) donors. Ureteric stenosis (6 cases 3%), ureteric obstruction (3 cases: 1.5%) and urinary leakage (5 cases: 2.5 %) were most of complications. Of 9 cases with rise of creatinine which had ureteral obstruction or stenosis percutaneous nephrostomy were performed, 2 of them endourologic Intervention Improved stenosis, seven of the 9 needed open surgery. Techniques of ureteral repair were included: Boari flap (2 cases) Uretero ureterostomy or pyeloureterostomy to native ureter in 4 cases and ureteroneocys to my in 1 case. At urinary leakage (5 cases), in 2 cases leakage were interrupted without surgery (by nephrostomy), in 3 cases surgical management (uretero uresteros tomy or pyelo uretero tomy to native ureter, and Boari flap and anastomose to transplanted kidney calices) had done. In this study most diagnostic method of urologic complications was sonography and best method to detect complication site was nephrostomography. Surgical techniques were selected upon to site and severity of complications. Results of operations were successful.



Volume : 2
Issue : 2
Pages : 88


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