Negative pressure wound therapy used to heal complex urinary fistula wounds following renal transplantation into an ileal conduit.
Transplantation into an ileal conduit is an established option for patients with end-stage renal failure and a nonfunctioning urinary tract. Urinary fistulae are more common following these complex transplants. Urinary fistula in this scenario can cause substantial morbidity and even result in graft loss. The management options depend on the viability of the transplant ureter, the level of local sepsis and the overall condition of the patient. Urinary diversion with a nephrostomy and ureteric stents has been described in aiding the healing of urinary leaks in renal transplants into a functioning urinary tract. We describe the successful use of negative wound pressure therapy to eradicate the local sepsis and help the healing of a recurrent urinary fistula following kidney transplantation into an ileal conduit. To our knowledge these are the first such cases reported in the literature.
Heap
Sarah
S
The Transplant Unit, Manchester Royal Infirmary, Central Manchester University Hospitals, Manchester, UK. sarahheap@hotmail.co.uk
Mehra
Sanjay
S
Tavakoli
Afshin
A
Augustine
Titus
T
Riad
Hany
H
Pararajasingam
Ravi
R
D000368:Aged; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D014547:Urinary Diversion / Q000009:adverse effects; D014548:Urinary Fistula / Q000209:etiology / Q000628:therapy*; D014570:Urologic Diseases / Q000601:surgery