[Urologic complication of renal transplantation. Importance of the length of the ureter]. / Complication urologique de la transplantation rénale. Importance de la longueur de l'uretère.

ABSTRACT

The authors report a series of 430 renal transplantations performed over five years. During this period, the surgical technique was modified to ureterovesical anastomosis. The urological complications--fistulae and stenosis--are discussed as a function of the site of the implantation, the position of the kidney, the type of anastomosis and the length of the ureter. The results show that transplantation in the iliac position gives rise to more complications than transplantation in the pelvic position. They also show that inversion of the superior pole of the kidney leads to a greater number of urological complications. In the series reported, ureterovesical anastomosis gave 6.7% of complications, against 12% for uretero-ureteral anastomosis, which also gave rise to a significantly larger number of fistulae. More detailed study of the series reveals a complication rate of 4.7% for ureterovesical anastomosis (out of 224 patients) against 4% for uretero-ureteral anastomosis, when the ureter was short (in both series). The dominant factor is therefore the length of the ureter; the longer it is, the greater the number of urological complications.