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ORIGINAL ARTICLE
Year : 2019  |  Volume : 13  |  Issue : 3  |  Page : 184-187

Posttransplant vesical calculi – A case series


Department of Urology and Renal Transplantation, Kamineni Institute of Medical Sciences, Nalgonda, Telangana, India

Correspondence Address:
Prof. V L. N Murthy Pisapati
Department of Urology and Renal Transplantation, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda - 508 254, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijot.ijot_5_19

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Background: The occurrence of posttransplant vesical calculi is rare. Suture material, used during ureteroneocystostomy, both absorbable and nonabsorbable have been implicated as the nidus for stone formation. We report five cases of renal transplant recipients, who developed vesical calculi several years after renal transplantation, and the nidus was the prolene suture. Methods: Between 1997 and 2010, 344 renal transplants were performed which included both cadaver and live-related transplantations. The ureteroneocystostomy was performed by modified Lich-Gregoir technique using 6–0 prolene as the suture material. All cadaver transplants and some of the live cases were stented. The Foley catheter was removed between 3 and 5 days, and DJ stent was removed between 4 and 6 weeks postoperatively. Standard triple drug immunosuppression was given and followed up at regular intervals. Results: Five patients developed small vesical calculi between 10 and 21 years after transplantation at the site of ureteroneocystostomy, and prolene suture was the nidus. There were three ureteric leaks postoperatively, two were due to ureteric necrosis requiring reconstruction, and one was due to anastomotic leak which subsided on prolonged bladder drainage. There was one case of ureteric obstruction in the immediate postoperative period which was stented. Conclusion: Nonabsorbable suture material, however fine it is, prompts stone formation in the long run and should be avoided during ureteroneocystostomy.


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