title: Urological complications in 980 consecutive patients with renal transplantation.
abstract: OBJECTIVE
  To present the urological complications of renal transplantations performed in the last 14 years at one center and to briefly explain a modified method of Lich-Gregoir ureteroneocystostomy.
  
  
  METHODS
  The data of 980 patients receiving kidney transplants at the authors' institution from April 1991 to February 2004 were reviewed in a retrospective prospective study. In particular, surgical techniques and urological complications were noted.
  
  
  RESULTS
  A total of 980 patients had received kidney transplantation. Extravesical ureteroneocystostomy (Lich-Gregoir method) was used in the first 480 patients (group A). In the subsequent 500 patients, the authors' modified method of extravesical ureteroneocystostomy, using single layer anastomosis and small feeding tubes as stent, was used (group B). Overall urological complication rate was 2.8% (28 patients), including leakage (13 patients, 1.3%), stenosis (seven, 0.7%), obstruction (one, 0.1%), distal ureter necrosis (four, 0.4%), pelvocalyceal fistula (two, 0.2%) and implantation of ureter into the peritoneum (one, 0.1%). Urological complications were significantly more common in group A compared to group B (16, 3.3% and 9, 1.8%, respectively; P < 0.05).
  
  
  CONCLUSIONS
  Preserving the adventitia, fat and blood supply of the ureter by delicate dissection of the ureter during donor nephrectomy, short ureters, and fixation of the adventitia, fat and blood supply of the ureter to the bladder wall, to prevent kinking or twisting, are important factors in decreasing urological complications. Additionally, the authors' method of ureteroneocystostomy is also effective in decreasing the incidence of ureteric complications.
authors.affiliation: Division of Surgery, Faghihi Hospital, Shiraz, Iran.
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Davari
authors.forename: Hooman
authors.initials: H
authors.lastname: Yarmohammadi
authors.forename: Seyed A
authors.initials: SA
authors.lastname: Malekhosseini
authors.forename: Heshmatollah
authors.initials: H
authors.lastname: Salahi
authors.forename: Ali
authors.initials: A
authors.lastname: Bahador
authors.forename: Mehdi
authors.initials: M
authors.lastname: Salehipour
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003559:Cystostomy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D014515:Ureteral Diseases / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D014519:Ureterostomy / Q000379:methods