Successful Boari Flap ureteroneocystostomy for distal ureteral necrosis after renal transplantation

摘要

Renal transplantation has been shown to improve the quality of life and overall survival in patients compared to long-term dialysis. However, the procedure is still often followed by surgical and medical complications.1 Urinary fistulas are one of the most frequent complications occurring within the first month after the transplant, occurring in 2%–4.7% of cases.2 It is usually associated with ischemic necrosis of the distal ureter which only receives vascularization through its superior pedicle originating from the renal artery. There are numerous ways to ensure urinary continuity in fistula cases, through either endoscopic or surgical methods. Even though there is a place for an endoscopic approach, the immediate success rate is 69% with a longerterm success rate of only 58% due to recurrent infections or stenosis.