Native ureteropyelostomy and ureteroneocystostomy in ureteral complications after renal transplantation

Abstract

Abstract

Introduction; There is no consensus regarding the standard surgical care after renal transplantation complications and mostly depends on the surgical team judgement. Therefore, in this study we tried to compare the outcomes of native ureteropyelostomy and ureteroneocystostomy in ureteral complications after renal transplantation.

Methods and materials; This was a case-control study performed in a referral center for kidney diseases. Patients underwent native ureteropyelostomy and ureteroneocystostomy according to the time passed from renal transplantation surgery. Finally, outcomes were compared between the two groups using SPSS software version 20. P-value below 0.05 was considered statistically significant.

Results; A total of 1316 kidney transplants were performed in our center during 2010 and 2020. Overall, 16 patients (1.21%) required a reconstructive surgery postoperatively. The main reasons for reoperation were stenosis in 11 patients (68.8%), leakage in 3, stenosis and leakage in one, and leakage and necrosis in another patient. Seven patients (43.8%) underwent native ureteropyelostomy and 8 (50%) ureteroneocystostomy. There was no significant difference between the two reconstructive surgical techniques in terms of patients' background characteristics, waiting time for transplantation, duration of preoperative dialysis, post-op complications, rejection or mortality rate and etc. Despite the fact, there was a significant difference between the two surgical techniques regarding the donor type. However, the trend of serum Cr changes between the two surgical techniques did not show a significant difference (p = 0.329).

Conclusion; Native ureteropyelostomy and ureteroneocystostomy were effective to treat post-op ureteral complications with good results. We suggest to perform native ureteropyelostomy if more than eight weeks have passed from renal transplantation and if distal ureter blood supply is under question.