Technical modifications of ureteroneocystostomy in renal transplantation: an 18-year experience.

The treatment of choice for patients with end-stage renal disease is renal transplantation.
Urinary tract reconstruction is usually done by anti-reflux ureteroneocystostomy, of
which there are several techniques. In this study, a comparison of previous studies related to
complications and outcome of various extra-vesical uereteroneocystostomy techniques that were
used in our center was made. From the year 1988, when renal transplantation was first performed
in our center, we utilized many ureteroneocystostomy techniques including Lich-Grigoir, Barry,
Tagochi, and finally Barry-Tagochi. With each conversion, we compared the results of the earlier
technique with the new one. In addition, we collected the results of four previous studies conducted
by our surgeons and analyzed the complications seen with ureteroneocystostomy. A total
of 717 renal transplant recipients were included in our study; 214 of these patients were reimplanted
by the Barry-Tagochi technique, 155 cases by the Barry technique, 44 cases by the
Tagochi technique, and finally, 304 cases by the Lich-Grigor technique. There was no significant
difference in the overall complications, urinary leakage and ureteral stenosis, and obstruction
between the four groups. However, complicated hematuria was significantly more frequently seen
in the Tagochi group (P = 0.002). Also, the mean time taken for ureteroneocystostomy was longer
in the Lich-Grigor group (P = 0.001). We found that the Barry-Tagochi technique had an overall
incidence of urological complications similar to that of the other extravesical techniques and was
less time consuming