Comparision of Barry and Barry-Taguchi Ureterovesical Reimplantation Techniques in Kidney Transplantations: A Randomized Clinical Trial

Abstract

Background: Renal transplantation is the treatment of choice for chronic renal failure. Using a suitable ureterovesical anastomosis technique can prevent most of risks for kidney graft. Extravesical ureteroneocystostomy 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.

Objective: In this study we assessed the effectiveness and complications of a new technique, Barry-Taguchi technique and compared it with Barry technique.

Methods: 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 technique) and Barry ureteroneocystostomy. The urological complications studied included complicated hematuria, urinary fistula, and ureteral stenosis.

Results: 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-implantation technique was 4% (n=4) and 5% (n=5%), respectively. These complications included 1 urinary leakage 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.

Conclusion: The Barry-Taguchi extravesical ureteroneocystostomy technique is a rapid and rather simple technique. Without increasing the incidence of urological complication rate, it is a reliable method for performing ureteroneocystostomy.