Establishment of standards for classification of urinary fistula after kidney transplantation
10.3760/cma.j.issn.1000-6702.2009.06.018
- VernacularTitle:肾移植术后尿瘘分类标准的建立
- Author:
Qiansheng LI
;
Zhilin NIE
;
Fengshuo JIN
;
Wenqian HUO
;
Fangqiang ZHU
;
Xiaobin CHENG
;
Jian HUANG
;
Qiang MA
;
Gang YUAN
- Publication Type:Journal Article
- Keywords:
Kidney transplantation;
Fistula;
Classification
- From:
Chinese Journal of Urology
2009;30(6):401-404
- CountryChina
- Language:Chinese
-
Abstract:
Objective To establish the standards for classification of urinary fistula after kidney transplantation. Methods From December 1993 to February 2009, 1313 cases of renal transplanta-tions were operated, out of which 102 cases of urinary fistulas occurred (7.8%). Based on the princi-ple of the urethral injury classification method, we divide urinary fistula into simple and complex clas-ses by the cause, location, and the severity of the disease. Results There were 81 cases (79.4%) of simple urinary fistulas, of those 76 cases were ureteral end necrosis,4 cases were due to ureter blad-der anastomosis suture,1 case was anastomotic problem caused by wound infection. There were 21 ca-ses(20.6%) of complex urinary fistulas, of these 2 cases had fistulas at renal pelvis, 11 cases at ure-ter-bladder interface and 6 cases had ureteral necrosis longer than 2 cm. For the 81 cases urinary fistu-las patients, 34 patients conservative treatments were cured and 47 patients need surgeries. For all complex urinary fistulas need surgeries: 11 cases had surgery once, 5 cases had 2 times, 3 cases had 3 times and 2 cases had 4 times. Among the 2 groups, three patients (2.9%) died of urinary fistulas which led to severe lung infection. Conclusions A "Five Steps Procedure" could be used for diagno-sis and treatment of post renal transplantation fistula. The urinary fistulas are divided into simple and complex types after renal transplantation. This provides a guidance for the best choice of treatment.
