title: Urinary fistula repair in a renal graft through a partial nephrectomy and omentoplasty.
abstract: OBJECTIVE
  We present the management with partial nephrectomy and interposition of the greater omentum in case of urinary fistulas in renal allograft.
  
  
  METHODS
  We present a patient with necrosis at the inferior pole of the renal graft that affected calyceal system but with pyeloureteral vascularization preserved. The patient's condition was satisfactorily managed with a partial nephrectomy of the necrotic renal segment and primary suturing of the collecting system with interposition of the greater omentum. We reviewed the cases published to date of partial nephrectomy in renal allograft, and examined their outcomes by analyzing the patient presentation, diagnostic tools, and surgical techniques used.
  
  
  RESULTS
  There are few cases in the current literature that describe conservative surgical management of urinary fistulas caused by segmental necrosis after renal transplantation. Surgical approach using partial nephrectomy in these cases produces favorable outcomes in our experience and reported cases.
  
  
  CONCLUSIONS
  Despite its obvious surgical complexity, this nephron-sparing management is feasible and should be implemented in cases where the prior renal function and the quantity of healthy parenchyma indicate a favorable subsequent evolution for the renal graft.
authors: Servicio de Urología, Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: fcampos@humv.es.
authors: F
authors: F
authors: Campos-Juanatey
authors: R
authors: R
authors: Ballestero-Diego
authors: J L
authors: JL
authors: Gutiérrez-Baños
authors: E
authors: E
authors: Hidalgo-Zabala
authors: L
authors: L
authors: Gala-Solana
authors: E
authors: E
authors: Mediavilla-Diez
mesh_terms: D006801:Humans; D007238:Infarction / Q000150:complications; D007668:Kidney / Q000098:blood supply; D007670:Kidney Calices / Q000473:pathology; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009392:Nephrectomy / Q000379:methods*; D009399:Nephrons; D009852:Omentum / Q000601:surgery*; D059351:Organ Sparing Treatments; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed; D014548:Urinary Fistula / Q000000981:diagnostic imaging / Q000601:surgery*