title: Impact of ureteral length on urological complications and patient survival after kidney transplantation.
abstract: BACKGROUND
  Urologic complications are of the most important complications after kidney transplantation which increases mortality and morbidity significantly.
  
  
  OBJECTIVE
  We designed this study to evaluate the association between ureteral length and postoperative complications.
  
  
  METHODS
  We recorded the length of the transplanted ureter during the operation. Ureter-to-bladder anastomosis was performed using modified Lich-Gregoir method on the ureteral stent. Complications like urine leakage and increased creatinine were evaluated. We used both univariate and multivariate analyses and survival analysis according lengths of ureter. It means that the main variable is ureteral length and other variables are studied based on it.
  
  
  RESULTS
  A total of 395 patients with the mean age of 37 years (range, 18 to 68 years) were enrolled in the study, twenty six graft lost during the follow-up period. The Mean age of recipients was 37 ± 13 years. Urinary stenosis was seen in 6 patients (1.5%) and urinary leakage in 4 (1%) patients. The complication rate was not significantly different between these groups (P = 0.67). We found that there were no significant difference among complication (P = 0.25), hospitalization (P = 0.31) and survival (P = 0.84) at 5.5 cm length cut off.
  
  
  CONCLUSIONS
  The length of transplanted ureter does not affect the postoperative urologic complications (including urinary fistula and ureter-to-bladder anastomosis stricture), and it seems that decreased rate of complication frequency during the recent years is due to technical improvement, surgeon's skillfulness and development in use of immunosuppressant's postoperatively.
authors.affiliation: Department of Urology, Shaheed Modarres Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Ali-Asgari
authors.affiliation: Department of Urology, Shaheed Modarres Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Farid
authors.initials: F
authors.lastname: Dadkhah
authors.affiliation: Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Ghadian
authors.affiliation: Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Nourbala
keywords: Complications; Kidney Transplantation; Ureter