| Journal: | International braz j urol |
| Database: | PERIÓDICA |
| System number: | 000296844 |
| ISSN: | 1677-5538 |
| Authors: | Mazzucchi, Eduardo1 Souza, Guilherme L Hisano, Marcelo Antonopoulos, Ioannis M Piovesan, Affonso C Nahas, William C Lucon, Antonio M Srougi, Miguel |
| Institutions: | 1Universidade de Sao Paulo, Divisao de Urologia, Sao Paulo. Brasil |
| Year: | 2006 |
| Season: | Jul-Ago |
| Volumen: | 32 |
| Number: | 4 |
| Pages: | 398-404 |
| Country: | Brasil |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Caso clínico, analítico |
| English abstract | OBJECTIVES: urinary fistula is a morbid complication after renal transplantation leading to graft losses and patient death. We review and update our data on urinary fistula after renal transplantation and the outcome after surgical and conservative management. MATERIALS AND METHODS: the charts of 1046 renal transplants were reviewed. Transplants were performed through an extended inguinotomy; vascular anastomoses to the iliac vessels and urinary reconstruction accomplished through the Gregoir technique. Fistulae were diagnosed by urinary leaks through the incision or by the occurrence of a collection in the iliac fossa. Patient was treated surgically or conservatively according to the characteristics of the fistula and patient clinical status. RESULTS: Thirty one fistulae were diagnosed (2.9%). Twenty nine leaks due to ureteral necrosis and 2 due to reimplantation fault. The incidence of leaks among cadaver and live donor transplants was 3.22% and 2.63%, respectively (p = 0.73). Among diabetic and non diabetic patients the incidence of urinary leaks was 6.4% and 2.6%, respectively (p = 0.049). Treatment consisted in anastomosis of the graft ureter or pelvis with the ureter of the recipient in 17 cases with success in 13 (76.5%). Prolonged bladder drainage was employed in 7 cases and the fistula healed in 4 (57%). Ureteral reimplantation was performed in 3 cases and did not work in any of them. Ureteral ligature plus nephrostomy was employed in two cases and worked in one (50%). Percutaneous nephrostomy and ureteral stenting with do |
| Disciplines: | Medicina |
| Keyword: | Cirugía, Terapéutica y rehabilitación, Fístulas, Vías urinarias, Trasplantes, Riñones, Cirugía reconstructiva |
| Keyword: | Medicine, Surgery, Therapeutics and rehabilitation, Fistulae, Urinary tract, Transplantation, Kidneys, Reconstructive surgery |
| Full text: | Texto completo (Ver HTML) |
