title: Management of urologic complications in renal transplantation: a single-center experience.
abstract: BACKGROUND
  Ureterovesical complications subsequent to renal transplantation are associated with a high morbidity leading to graft loss or even death. In the present study, the management of these complications by using interventional and surgical procedures (native pyeloureterostomy [NPUS]/ureteroureterostomy [NUU] vs ureteroneocystostomy [UNC]) was evaluated retrospectively.
  
  
  METHODS
  Between 1994 and 2012, a total of 780 kidney transplantations (690 deceased and 90 living donors) were performed at our institution. Demographic, clinical, and laboratory data from patients with urologic complications were analyzed and compared.
  
  
  RESULTS
  Fifty patients (6.4%) exhibited ureterovesical complications, and 18 patients (36%) were operated on immediately. In 32 (64%) of 50 patients, an interventional procedure was initially performed, with 21 patients (66%) undergoing operation due to therapy failure. NPUS/NUU and UNC were performed in 26 (66.6%) and 13 (33.3%) patients, respectively. Indications for an operation were ureteral stenosis in 12 patients (30.8%), ureteral necrosis and urine leakage in 19 patients (48.7%), and symptomatic vesicoureteral reflux in 8 patients (20.5%). Long-term results were comparable between all groups.
  
  
  CONCLUSIONS
  Surgical revision of ureteral complications should be the standard therapy. NPUS/NUU, UNC, and the successful interventional procedures did not differ significantly in terms of long-term results.
authors.affiliation: Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany. Electronic address: hansmichael.hau@medizin.uni-leipzig.de.
authors.forename: H M
authors.initials: HM
authors.lastname: Hau
authors.affiliation: Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: H-M
authors.initials: HM
authors.lastname: Tautenhahn
authors.affiliation: Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schmelzle
authors.affiliation: Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Krenzien
authors.affiliation: Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany; Department of General, Visceral, Transplantation, Vascular, and Thoracic Surgery, Ludwigs Maximilian University Hospital, Campus Großhadern, Munich, Germany.
authors.forename: M B
authors.initials: MB
authors.lastname: Schoenberg
authors.affiliation: Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: M H
authors.initials: MH
authors.lastname: Morgul
authors.affiliation: Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Uhlmann
authors.affiliation: Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Wiltberger
authors.affiliation: Department of Endocrinology and Nephrology, Section for Nephrology, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Rasche
authors.affiliation: Department of Endocrinology and Nephrology, Section for Nephrology, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Bachmann
authors.affiliation: Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Jonas
authors.affiliation: Department of Visceral, Transplantation, Thoracic, and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bartels
mesh_terms: D005260:Female; D005858:Germany; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D014570:Urologic Diseases / Q000209:etiology / Q000628:therapy*