INTRODUCING A NEW URETERONEOCYSTOSTOMY TECHNIQUE FOR TRANSPLANTATION PATIENTS.

Renal transplantation is the choice of treatment for chronic renal failure. Applying suitable ureterovesical anastomosis technique can prevent most risks for kidney graft. Extravesical ureteroneocystostomy is becoming popular in renal transplantation because of the low complication rate and technical ease. This decrease in complication was due to limited bladder dissection and the need for a shorter ureteral segment from the donor. We evaluated the incidence of urologic complications by using Barry-Tagochi ureteroneocystostomy in 114 cases of renal transplantation.

Materials & Methods: We recorded all urological complications after preforming extravesical Barry-Tagochi (new technique) ureteroneocystostomy in the recipient kidney that was developed from Sep 2004 to Sep 2005 (mean follow-up 12 mouths). The urological complications included complicated hemturia, urinary fistula, ureteral stenosis, VUR, and operative time. All patients underwent baseline VCUG and ultrasonography within 3-6 months of transplantation and as clinically indicated

Results: The incidence of urological complications was 6 (5.25%) patients that included one urinary leakage (0.86%) and four ureteral stenosis (3.5%) which the ureters required reimplantation, with one complicated hematuria (0.86%) and with any symptomatic VUR, range of operative time was 4 minutes (mean 8.15). Mild reflux was noted in 2 patients in VCUG and reoperation was not required.

Conclusion: Extravesical Barry-Tagochi (new technique) ureteroneocystostomy is a simple and rapid technique with acceptable urologic complications so this technique is the first choice of our center.