Urological complications of renal transplantation

Urinary fistula and ureteral stenosis occur respectively in 2-5% and 2-7.5% after kidney transplantation. The aim of the study was to do an overview about the complex management of these complications. A bibliographical research in French and English language was carried out. Debates on the topic held within a meeting organized by the transplantation Committee of the French association of urology (CTAFU) have incremented the work. Within the different causes of stenosis and fistula after kidney transplantation, ischemic diseases of the complex blood supply of the ureter are usually involved. The diagnosis is not always easy to establish. It is based on clinical assessment, blood and urinary biochemical exams, ultrasonography and CT-scan. Pyelography or retrograde ureteropyelography are essential in the management. Definitive treatment is surgical: uretero-vesical reimplatation, uretero-uretral anastomosis, pyelo-ureteral anastomosis. Urologic complications of the kidney transplantation usually do not affect the transplant survival if treated accurately and on time. The surgical management remains complex.