Abstract:

OBJECTIVE: Complication incidence of urinary fistula which frequently occurs following renal transplantation is 3%-10%. Thus, poor processing may cause loss of transplanted kidney. This study was designed to retrospectively analyze urinary fistula following renal transplantation and to summarize the processing experience.
METHODS: A total of 27 out of 1 203 patients with urinary fistula following renal transplantation (16 males and female 11 and mean age of 43 years) were collected from Guangzhou General Hospital of Guangzhou Military Command of Chinese PLA from December 2000 to March 2009. Totally, 26 patients accepted donor kidney from corpse, and 1 from living body. All patients were treated with expectant treatment (n=17) including inserting 18Fr Foley catheter alone and draining from the native drainage channel of operative site (n=12) and inserting a ureteral stent (single-J) by cystoscope retrograde approach and inserting 18Fr Foley catheter into the bladder (n=5); exploring operation (n=10) including anastomosing ureter and bladder and placing ureteral stent (n=5) and anastomosing ureter and ureter of recipient and placing ureteral stent (n=5); pedicled omentum grafts to cover and surround stoma after suturing (n=6).
RESULTS: Only 1 case was failed because kidney vain was injured in the second operation and the kidney was resected. Another 26 cases were cured. Within the 3 month to 7 years follow-up, the urinary fistulas did not relapse, no stegnosis or hydronephrosis, no urinary tract infection and renal function were normal.
CONCLUSION: Rapid diagnosis and treatment for urinary fistulas after renal transplantation is imperative. First mostly patients may be cured by expectant treatment. If not then perform exploratory operation. Using pedicled omentum grafts to cover and surround stoma after suturing for complex urinary fistulas can raise achievement ratio of operation.