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Pyeloureterostomy or Ureteroneocystostomy in Renal Transplantation?
Author(s) -
LANDAU R.,
BOTHA J. R.,
MYBURGH J. A.
Publication year - 1986
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1986.tb05417.x
Subject(s) - medicine , nephrectomy , hydronephrosis , anastomosis , surgery , ureter , urinary system , urology , kidney transplantation , urinary leakage , transplantation , complication , sepsis , kidney , urinary incontinence
Summary— A retrospective comparison of pyeloureterostomy and external ureteroneocystostomy as methods of reconstructing the urinary tract in 128 renal transplants is presented. There was one urological complication in 52 pyeloureterostomies (1.9%) compared with 4 in the 76 ureteroneocystostomies (5.3%). 6/0 Polydioxanone (PDS) is preferred to Prolene for the anastomosis because of possible calculus formation on the latter. Wound sepsis is commoner in pyeloureterostomies undergoing concomitant nephrectomy, despite prophylactic antibiotics, though this is not statistically significant and the overall sepsis rate is higher for ureteroneocystostomy. Nephrectomy was avoided in 17 selected cases by simply ligating the recipient ureter where the pre‐transplant urine output was low. Two of these patients developed hydronephrosis in the isolated kidney and required later nephrectomy.