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Query: UMLS:C0403608 (ureter)
 9,655 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the period from 1 January 1992 through 31 December 1995, a total of 582 renal transplantations were performed at the Department of Cardiovascular and Transplant Surgery of the Prague-based Institute for Clinical and Experimental Medicine. This number does not include combined kidney and pancreas transplantations. In 571 cases, the kidney was transplanted from a cadaveric donor while living related donors were involved in 11 cases. Of the 582 procedures, 515 were first transplantations while the remaining 67 were re-transplantations. The most frequent surgical procedure was lymphocele developing in 70 patients. Urinary fistula was present in 39 patients while 21 patients developed early obstruction or stenosis of the ureter. Other complications included graft rupture, bleeding, vascular thrombosis and a rare case of bowel perforation. Surgical complications required graft nephrectomy in 27 cases (4.6%).
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PMID:[Surgical complications after kidney transplantation]. 901 64

Urinary fistula is a common complication after kidney transplantation and may lead to graft loss and patient death. Its current incidence ranges from 1.2% to 8.9%. From December 1993 to April 2007, 1223 kidney transplant procedures were performed by our kidney transplantation team. In 948 recipients (group 1), we performed an extravesical ureteroneocystostomy, and in 275 recipients (group 2), a terminoterminal ureteroureterostomy (UU). We observed urinary fistulas in 43 patients (3.5%), with mean onset at 6 days (range, 3-20 days) posttransplantation. Urinary fistula was significantly more common in group 1 compared with group 2 (4.1% and 1.5%, respectively; P < .05). The distal ureteral necrosis was the major frequent cause of urinary fistula (n = 34; 76.7%), which required either a second ureteroneocystostomy or UU using the native ureter. Of these 21 fistulas, including 10 recurrent fistulaes, were successfully treated with pedicled omentum covering the anastomotic stoma. Conservative treatment with a stent and Foley catheter drainage for 1 to 2 weeks was successful in 8 patients. All patients with a urinary fistula regained normal graft function except 1 in whom transplant nephrectomy was necessary because of pelvic and ureteral necrosis. There was no recipient loss secondary to urinary fistula. In conclusion, UU can decrease the incidence of urinary fistula after kidney transplantation. Most urinary fistulas require surgical management; and pedicled omentum is useful to repair the fistula.
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PMID:Treatment of urinary fistula after kidney transplantation. 1954 93

Transplantation into an ileal conduit is an established option for patients with end-stage renal failure and a nonfunctioning urinary tract. Urinary fistulae are more common following these complex transplants. Urinary fistula in this scenario can cause substantial morbidity and even result in graft loss. The management options depend on the viability of the transplant ureter, the level of local sepsis and the overall condition of the patient. Urinary diversion with a nephrostomy and ureteric stents has been described in aiding the healing of urinary leaks in renal transplants into a functioning urinary tract. We describe the successful use of negative wound pressure therapy to eradicate the local sepsis and help the healing of a recurrent urinary fistula following kidney transplantation into an ileal conduit. To our knowledge these are the first such cases reported in the literature.
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PMID:Negative pressure wound therapy used to heal complex urinary fistula wounds following renal transplantation into an ileal conduit. 2121 67