Retrocaval ureter: a study of 13 cases.

INTRODUCTION: The aim of this study was to report our 23-year experience in the diagnosis and treatment of retrocaval ureter. MATERIALS AND METHODS: Data from 13 patients with retrocaval ureter were reviewed. Intravenous urography and retrograde pyelography had been used for confirming the diagnosis. All of the patients had been symptomatic and undergone surgery. A control intravenous urography had been performed 6 months postoperatively. RESULTS: The mean age of the patients was 23 years (range, 12 to 37 years). Twelve patients (92.3%) were men. The clinical manifestations were pyelonephritis in 7 (53.8%), right flank pain in 4 (30.8%), gross hematuria in 1 (7.7%), and ureteral calculus in 1 (7.7%). All of the patients had type 1 right-sided retrocaval ureter. Associated anomalies were seen in none of the patients. The control intravenous urography showed improvement of renal function. CONCLUSION: In our patients, the most common cause of referral was pyelonephritis. In symptomatic cases, operation is needed and can improve renal function.

Kidney transplantation in older adults: does age affect graft survival?

INTRODUCTION: There is a paucity of data on long-term patient and graft survival in the older kidney recipients. Our aim was to evaluate the long-term outcomes of kidney transplantation in patients aged 50 years and older and compare them with outcomes in younger recipients. MATERIALS AND METHODS: Forty-seven recipients aged 50 years and older and 47 recipients aged younger than 50 years were randomly assigned to two groups (groups 1 and 2, respectively). Patients who had received a cadaveric kidney allograft were excluded from the study. Data including demographic and clinical characteristics, early complications, early mortality, and actuarial patient and graft survival rates were collected, and the two groups were compared, accordingly. RESULTS: The rates of early complications and mortality were not different between the two groups. Patient survival rates at 1, 3, 5, and 7 years were 72%, 58%, 41%, and 41% for patients in group 1 and 95%, 86%, 86%, and 86% for patients in group 2, respectively (P = 0.007). Graft survival rates were 72%, 58%, 41%, and 41% for patients in group 1 and 95%, 85%, 85%, and 85% for patients in group 2, respectively (P = 0.006). Graft loss due to patient death was 33.33% in group 1 compared with 4.25% in group 2 (P < 0.001). CONCLUSION: Kidney transplantation should be considered in patients older than 50 years, since the graft survival rate is acceptable in this population, and early mortality and complications in this group are not different than those of younger recipients. Although older patients have a shorter life expectancy, they benefit from renal transplantation in ways similar to younger kidney transplant recipients.