ORIGINAL ARTICLE   

Minerva Urologica e Nefrologica 2018 August;70(4):422-8

DOI: 10.23736/S0393-2249.18.03078-3

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Minimally invasive approach for the management of urological complications after renal transplantation: single center experience

Orkunt ÖZKAPTAN ¹ ✉, Cuneyd SEVINC ², Muhsin BALABAN ², Tahir KARADENIZ ¹

¹ Liv Hospital Ulus, Istanbul, Turkey; ² Medicana International Hospital, Istanbul, Turkey

BACKGROUND: The aim of the study was to characterise urological complications after renal transplantation and to evaluate the role of minimally invasive management for urological complications.
METHODS: A total of 920 kidney transplantations were performed between 2008 and 2015. All patients were followed up for at least 1 year after transplantation. Complications regarded as urological were urinary leakage, ureteral stricture, urinary malignancy, bladder outlet obstruction (BOO) and urinary calculi. We evaluated data from the time of occurrence of urological complications and the type of the management prescribed.
RESULTS: Among 920 transplantations performed in our clinic, 41 (4.4%) urological complications arose. Twenty (48.8%) of the complications occurred during the first 3 months and 21 (51.2%) occurred after 3 months, postoperatively. Ureteral strictures were found in 14 (34.1%) patients, urinary tract stones in seven (17%), BOO in 6 (14.6%) and urinary leakage was observed in 5 (12.1%) patients. Ureteral stricture was managed with endoscopic approach in eight (61.3%) patients. Urinary tract stones and urinary leakage were managed in 7 (100%) and 4 (75%) patients with endoscopic approach. Overall 29 (70.7%) of 41 urological complications were managed with endourological approaches.
CONCLUSIONS: It is likely that the importance of open surgery could decrease in the future. Endoscopic management of urological complications have come to have an important role in the treatment of urological complications after transplantation.

KEY WORDS: Kidney - Minimally invasive surgical procedures - Therapeutics