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Volume: 6 Issue: 4 November 2008 - Supplement - 1



Urologic complications are one of the most common complications after renal transplantation. Early diagnosis and suitable treatment can preserve function of transplanted kidney. In this study incidence of urologic complications, surgical techniques and results of treatment were evaluated. During 1989-2007, 1000 renal transplantation 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 included: serum creatinine level, renovesical ultrasonography, radio­isotope scanning and nephrostomogram. From 200 cases, 14 cases had complications (7%) Mean age of patients were 29 y(11-48 ) and complications occurred between 12th and 950th days (mean 147 days) after transplantation . Patients had received graft from : living unrelated (9 cases ), living related (1 cases ), and cadaver (4 cases). Ureteric stenosis (6 cases: 3%), ureteric obstruction (3 cases: 1.5%) and urinary leakage (5 cases: 2.5 %) were most commom complications. In 9 cases with rise of creatinine which had ureteral obstruction or stenosis percutaneous nephrostomy were performed, and in 2 of them endourologic intervention improved stenosis. Seven of the 9 needed open surgery. Techniques of ureteral repair were: Boari’s flap (2 cases), uretero-ureterostomy or pyelo-ureterostomy to native ureter in 4 cases and ureteroneocystostomy in 1 case .In urinary leakage (5 cases), in 2 cases leakage were stopped without surgery (by nephrostomy), and in 3 cases surgical management (uretero-uresterostomy or pyelo-ureterostomy to native ureter , and Boari flap and anastomosis to transplanted kidney calyces) were done . In conclusion: in this study the most diagnostic method of urologic complications was sonography and the best method to detect complication site was nephro­stography. Surgical techniques were selected upon the site and severity of complications. Results of operations were successful.

Volume : 6
Issue : 4
Pages : 88

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Urology Research Center,Sina Hospital,Tehran University Of Medical Sciences,Tehran,Iran