Techniques of ureteric reimplantation in kidney transplantation and its related urological complications

Abstract

Two common techniques of ureteric reimplantation for kidney transplantation, the Politano-Leadbetter and the extravesical ureteroneocystostomy are described in detail. Correct techniques of donor ureter harvesting, appropriate method of reimplantation and judicious use of double J stent are also emphasised so as to reduce the urological complications which occurred in about 7% to 15% in most series. More than 90% of urological complications are due to urinary fistulae and ureteric obstruction which carry a significant morbidity and mortality. The causation, diagnosis and management of these complications are reviewed. Early diagnosis and early aggressive surgical treatment is the key to a successful outcome.