[Urologic complications of renal transplantation. Role of the length of the ureter].

Four hundred and thirty renal transplantations have been performed over a 5-year period during which there was a switch of surgical technique towards uretero-vesical anastomosis. In this paper, the urological complications observed are studied according to the site of transplantation, the position of the kidney, the type of anastomosis and the length of the ureter. Kidneys that were transplanted in iliac position gave rise to more complications than those transplanted in pelvic position, and reversing the kidney increased the number of urological complications. The complication rate was 6.7% with the uretero-vesical anastomosis and 12% with the uretero-ureteral anastomosis. The best results were obtained when the kidney was transplanted into the iliac fossa in pelvic position with its upper pole upward and its ureter anastomosed with the bladder: in 274 transplantations performed with this technique the complication rate was 4.7%. This study of different types of transplantation shows that the main factor is the ureteral length utilized: the longer that segment of the ureter, the more numerous the urological complications.