title: Intravesical ligation as a new technique to manage a refluxing native ureter without simultaneous nephrectomy in renal transplantation.
abstract: BACKGROUND
  This article aims to describe an original technique to correct refluxing native ureters observed during a prerenal transplantation study. The correction is performed by intravesical ligation of the native refluxing ureters at the same time as renal transplantation without simultaneous nephrectomy.
  
  
  METHODS
  Between January 2004 and December 2010 we performed intravesical ligation of a refluxing ureter simultaneous with a transplantation procedure without a concomittant native nephrectomy in 12 of 345 subjects (3.47%). The 8 bilateral and 4 unilateral ligations were performed on 11 cadaveric and 1 living-related nonidentical donor transplantations. The implantation of the kidney donor ureter was performed anatomically in the bladder trigone through a transvesical ureteroneocystostomy with a transmural, submucosal antireflux tunnel.
  
  
  RESULTS
  Early and late postoperative recovery was satisfactory in all patients. There was no documented kidney area pain, proven urinary tract infection, morbidity or mortality attributed to the procedure.
  
  
  CONCLUSIONS
  Intravesical ligation is a practical technique to manage vesicoureteral reflux into the native ureters simultaneously with the ureteral implantation of the kidney donor in a single surgical renal transplant procedure without native kidney nephrectomy.
authors.affiliation: Fundación Universitaria de Ciencias de la Salud, Facultad de Medicina, Servicios de Urología y Transplante Renal, Hospital de San José, Bogotá, Colombia. jeguz16@yahoo.com
authors.forename: J A
authors.initials: JA
authors.lastname: Guzmán
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003559:Cystostomy; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects; D008026:Ligation; D019520:Living Donors; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014513:Ureter / Q000637:transplantation*; D014519:Ureterostomy; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000601:surgery*; D055815:Young Adult