Urological complications in renal transplantation: Impact of a change of technique

Objective To determine whether the change from the Leadbetter-Politano technique to a stented extravesical technique for the vesico-ureteric anastomosis in renal transplantation has altered the incidence of urological complications. Patients and methods Data were retrieved from a prospective computerized database and by case-note review on 248 consecutive renal transplants performed between January 1990 and June 1996. The characteristics of the donor, recipient and organ were noted, together with the technique used for the vesicoureteric anastomosis and the occurrence of major and minor urological complications. Results The Leadbetter-Politano technique was used in 140 transplants and the stented extravesical technique in 108. There were no significant differences in the donor, recipient or organ characteristics between the groups. The stented extravesical technique was associated with a significantly lower rate of major complications (<2%) and clinically significant haematuria than with the Leadbetter-Politano technique. Conclusion Changing from the Leadbetter-Politano technique to a stented extravesical technique for the vesico-ureteric anastomosis has been a major factor in reducing the incidence of urological complications in our transplant practice.