Comparision of barry and barry-taguchi ureterovesical reimplantation techniques in kidney transplantations: a randomized clinical trial

ABSTRACT

Renal transplantation is the treatment of choice for chronic renal failure. Using a suitable uretero- vesical anastomosis technique can prevent most of risks for kidney graft. Extravesical ureteroneocystos- tomy is becoming popular in renal transplantation because of the low complication rate and technical ease. The decreased complication rate is due to limited bladder dissection and the need for a shorter ureteral segment from the donor. In this study we assessed the effectiveness and complications of a new technique, Barry-Taguchi technique and compared it with Barry technique. We recorded all urological complications developed in the recipient's kidney between September 2004 and March 2007 [mean follow-up 12 months] after performing extravesical Barry-Taguchi [new tech- nique] and Barry ureteroneocystostomy. The urological complications studied included complicated hema- turia, urinary fistula, and ureteral stenosis. A total 100 patients who underwent Barry-Taguchi technique and 98 patients who underwent Barry technique were studied. The incidence of urological complications in Barry-Taguchi and Barry re-implan- tation technique was 4% [n=4] and 5% [n=5%], respectively. These complications included 1 urinary leak- age and 3 ureteral obstructions for Barry-Taguchi technique, and 4 obstructions and 1 leakage from Barry group. In both trial groups, no complicated hematuria has occurred. In addition, the recorded time taken for ureteral anastomosis ranged from 4 to 16 [mean 8.3] min for Barry-Taguchi technique and 5 to 20 [mean 9.9] min in Barry technique. The Barry-Taguchi extravesical ureteroneocystostomy technique is a rapid and rather simple tech- nique. Without increasing the incidence of urological complication rate, it is a reliable method for perform- ing ureteroneocystostomy