Management of Ureteral Complications in Renal Transplantation: Prevention and Treatment.
Asadpour A, Molaei M, et al.Saudi Journal of Kidney Diseases & Transplantation, 22(1): 72-74, 2011.
Aims
To compare the effect of two ureteral spatulation lengths on ureteral complications in renal transplant recipients.
Interventions
The ureter was extravesically implanted with spatulation length less than 10 mm versus spatulation length greater than 10mm. In all patients, the ureter was implanted by the Lich-Gregoir technique with retention of the double J stent for at least six weeks.
Participants
170 kidney transplant recipients.
Outcomes
Ureteral complications and mortality related to urological complications. Ureteral complications included urine leakage and ureteral stenosis.
Follow-up
Average 13 months
CET Conclusions
In this rather poor quality study, patients were randomised to have the ureter implanted extravesically either with spatulation less than 10 mm in length or spatulation greater than 10mm in length. All patients had a double J stent left in situ for 6 weeks. Ureteric complications occurred a little more frequently in the group with the short spatulation than in the group with the longer spatulation and the authors conclude that ureteric spatulation of more than 10mm has a role in preventing ureteric stenosis. The evidence is flimsy to say the least.
Data analysis
Per protocol analysis
Trial registration
Not reported