ABSTRACT

Urinary extravasation is an uncommon complication of antireflux surgery. Typically this occurs in cases where the bladder is opened and extensive dissection of the ureteral hiatus is necessary. The fundamental aim of reimplantation is to halt reflux and thereby prevent the ascension of bacteria to the kidney and the subsequent development of pyelonephritis and renal scarring. The other aims are the prevention of the sequellae of scarring, namely hypertension and renal insufficiency. Patients with Vesicoureteral reflux (VUR) and end-stage renal failure requiring renal transplantation pose particular concerns. Transient voiding disturbances are normal in the immediate postoperative period. The treatment of VUR by the subureteric injection of dextranomer/hyaluronic acid offers a less invasive alternative method of treating VUR. Most renal transplant ureters are anastomosed to the bladder by a dismembered extravesical method. Complications after renal transplantation are evaluated and managed similar to those of other reimplanted ureters with one major difference.