A Comparison between Barry and Barry-Tagochi Ureterovesical Reimplantation Techniques in Kidney Transplant Recipients

Abstract

Background and Objectives: Renal transplantation is the treatment of choice for chronic renal failure. Using an appropriate and fine ureterovesical anatomizes technique can prevent most complications regarding this aspect of transplantation. Extravesical ureteroneocystostomy is becoming more popular in renal transplantation because of ITS few complications and technical ease. This low complication rate is due to limited bladder dissection and shorter urethral segment required from the donor. In this study, we evaluated a comparison between Barry and Barry-Tagochi ureteroneocystostomy techniques in a group of renal transplant recipients. Method and Materials: From September 2004 to March 2007, we recorded all urological complications after renal transplantation in a sort of renal transplant recipient. They were operated by Barry-Tagochi or Barry ureteroneocystostomy techniques. We followed them up to 12 mouths. For the following complications including: urinary fistula, urethral stenosis and vesicoureteral reflux and complicated hemturia. Results: From a total number of 198 patients 100 Barry-Tagochi and 98 Barry anatomizes were performed. The incidence of urological complications in Barry-Tagochi and Barry reimplantetion techniques were 4(4%) and 5(5.1%) respectively. The difference was not statistically significant (P=0.71). Urinary leakage occurs in one person in each group (%).and urethral obstruction occurred in 3 patients in each group (%).No complicated hematuria or symptomatic VUR happened in patients in each groups. The mean urethral anatomists time was recorded about 8.26±2.28 minutes (range 4-16 minutes) for Barry- Tagochi and 9.9± 3.34 minutes (range 5-20 minutes) for Barry procedure, with a significant difference (P=0.0001). After VCUG mild to moderate reflux was noted in 2(4%) of 50 transplant patients in Barry- Tagochi group. No treatment was required for a total number of 50 these patients. Conclusion: Our study proved that Barry –Tagochi extravehicular ureteroneocystostomy could be a rapid and simple method, without significant incidence of urological complication. This technique has become the choices of urethra vesicle anatomists during renal transplantation in our centre.