Urological complications in renal transplantation.

The urological complications associated with 128 consecutive renal transplants performed in the Department of Urology of the University Hospital Heidelberg between February 1967 and January 1975 are described. Extravesical ureteroneocystostomy has shown to be the preferable method for urinary tract reconstruction, providing satisfactory results in our hands. The technique of ureteroneocystostomy at the dome of the bladder, performed since 1967 in our series, is described and its advantages discussed. There was an overall incidence of urological complications of 21.2%. Major urological complications occurred in 18 patients (14.1%), urinary fistulae in 11 patients (8.6%), ureteric obstruction in 4 patients (3.2%) and spontaneous parenchymal ruptures in 3 patients (2.3%). Only two grafts were lost, due to spontaneous parenchymal ruptures. The mortality directly due to major urological complications was 5.6%. Minor complications (hydrocele, epididymitis, urethral stricture, urinary calculi) were seen in 9 patients (7%). Lymphoceles were not encountered. The management and outcome of urological complications are described.