[The use of double J stent for prevention of urological complications in kidney transplants]. / Empleo del catéter doble J para la prevención de las complicaciones urológicas en el trasplante renal.

OBJECTIVE: To analyze the impact of the use of the double J stent in the incidence of urological complications, like fistula urinary and ureteral obstruction in kidney transplants. MATERIALS AND METHODS: Between August 2003 and December 2005, 59 adult recipients underwent renal transplant. A retrospective study was conducted on two groups of patients: Group A with double J stent and group B without it. We reviewed the urological complications: fistula, ureteral obstruction and urinary tract infection. RESULTS: Group A: One ureteral obstruction and two urinary fistulas (7%) were developed in this group. 13 patients (46%) had a positive urinary culture. In only one case was necessary to retire the double J stent because of ureteral obstruction. Group B: Four patients (13%) developed ureteral obstruction and another five (16%) developed urinary fistula. 9 patients (29%) had a positive urinary culture. CONCLUSION: The routine insertion of a double J stent in kidney transplants reduces the number of early complications urinary fistula and ureteral obstructions.

[Ectopic ureter as cause of pyonephrosis and urinary incontinence]. / Uréter ectópico como causa de pionefrosis e incontinencia urinaria.

Ectopic ureter accounts with an incidence of 1 in 2000 newborns. When present, ectopic ureter can be associated with duplex kidneys in an 85 % of the cases. Clinical manifestations of this malformation include incontinence and urinary tract infections. Ectopic ureter frequently occurs in association with a dysplastic upper pole renal moiety. When a poorly functioning upper pole segment is present, a standard surgical treatment is upper pole heminephrectomy. A 23-years old woman presented with left renal colic pain, fever and urinary leak. Ultrasound, intravenous pyelogram and antegrade pyelogram revealed a partial duplex right kidney and a complete duplex left kidney with hydronephrosis and ectopic insertion into the urethra of the left upper pole moiety. Following diagnosis upper pole heminephrectomy and partial ureterectomy was performed.