title: Early and late urological complications corrected surgically following renal transplantation.
abstract: The purpose of this study was to assess outcomes of urological complications after kidney transplantation operation. Nine-hundred and sixty-five patients received a kidney transplant between 2000 and 2006. In total, 58 (6.01%) developed urological complications, including urinary leakage (n = 15, 1.55%), stenosis (n = 29, 3%), vesicoureteral reflux (VUR) (n = 12, 1.2%), calculi (n = 1, 0.1%) and parenchymal fistulae (n = 1, 0.1%). Urinary leakage cases were treated by ureteroneocystostomy (UNS) via a double-J stent and stenosis cases by UNS. Fenestration was performed in patients developing lymphoceles and unresponsive to percutaneous drainage. VUR treatment was performed by ureteroneocystostomy revision or UNS. Stent usage during ureteric reimplantation was observed to reduce urinary leakage. Surgical complication rates in renal transplantation recipients according to donor type (living versus cadaveric) and the status of stent use (with stent versus without stent) were 5.53% vs. 7.27% (P = 0.064) and 5.24% vs. 20% (P < 0.01) respectively. No recurrence, graft loss or death was seen after these interventions. Comparison of recipients with and without urological complication showed that there was no difference between groups (P > 0.05) with respect to last creatinine level. No graft or patient loss was associated with urological complications. Urological complications that can be surgically corrected should be aggressively treated by experienced surgeons and graft loss avoided.
authors.affiliation: Akdeniz University Transplantation Center, Antalya, Turkey. adinckan@akdeniz.edu.tr
authors.forename: Ayhan
authors.initials: A
authors.lastname: Dinckan
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tekin
authors.forename: Serdar
authors.initials: S
authors.lastname: Turkyilmaz
authors.forename: Huseyin
authors.initials: H
authors.lastname: Kocak
authors.forename: Alihan
authors.initials: A
authors.lastname: Gurkan
authors.forename: Okan
authors.initials: O
authors.lastname: Erdogan
authors.forename: Murat
authors.initials: M
authors.lastname: Tuncer
authors.forename: Alper
authors.initials: A
authors.lastname: Demirbas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013997:Time Factors; D014421:Turkey / Q000453:epidemiology; D014570:Urologic Diseases / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000379:methods*