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Volume: 4 Issue: 2 December 2006 - Supplement - 1

FULL TEXT

NEW TECHNIQUE FOR ALLOGRAFT URERTERAL URETERONEOCYSTOMY TO MAKE POSSIBLE TRANSVESICAL ENDOSCOPIC HANDLING ALLOGRAFT UROLOGIC COMPLICATION

Despite improvement in prevention,diagnosis ,and treatment as well as the use of new immunosuppressive therapies in kidney transplantation the incidence of urological complication after kidney transplantation varies from 3% to 14%, with a probable loss of the graft in 10% to 15% of cases and a mortality rate of up to 15%,. Ureteral complication represents a one of significant source of morbidity they consist of ureteral junction obstruction, leakage, ureteral necrosis and ureteral stricture. Due to position of neoureteral orifice, endoscope evaluation and transvesical treatment is not possible and always prercutanous approach recomended which is more invasive than transvesical. Here is a technique represent in which transvesical approach to allograft ureter is possible. In thirty kidney recipients after vessel anastomosing ureter is tailored for Dom and lateral of bladder (as much as possible near to dome of bladder and deep in lateral of it) mucosa to mucosa anastomosing carried out. In all of them DJ has been inserted. They followed for one year and the result compared with another thirty cases that in them our conventional ureteroneocystostomy performed. At the time of removing DJ the ureter was investigated for inserting ureteral catheter and ureteroscopy, that it easily done, and compared with thirty case control that in all of them transvesical approach was difficult and impossible. This technique contains: short ureter (so less complication with ureter), ureter to mucosa (normal appearing orifice of allograft ureter in the bladder) lateral ureter (retro grade approach possible). They followed at least for one year with ultrasound and laboratory examination, there was not any abnormality (hydroneprosis) and ureteral complication. This technique is safe and with this method retrograde handling of allograft ureter is possible and it seems that it associated with less ureteral complication.



Volume : 4
Issue : 2
Pages : 115


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