Intravesical versus extravesical ureteroneocystostomy in kidney transplantation: A systematic review and meta-analysis

Inez K.B. Slagt, Karel W.J. Klop, Jan N.M. Ijzermans, Türkan Terkivatan*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

20 Citations (Scopus)

Abstract

Urological complications are still a major problem postoperatively with a reported incidence of up to 30%, associated with significant morbidity, mortality, prolonged hospital stay and high medical costs. To date, there is no evidence favouring either an extravesical or an intravesical approach. The purpose of this systematic review and meta-analysis is to determine if an intravesical or extravesical anastomosis in kidney transplantation is to be preferred. Comprehensive searches were conducted in PubMed, Embase and the Cochrane Library. Reference lists were searched manually. The methodology was in accordance with the PRISMA statement. Two randomized controlled trials and seventeen cohort studies were identified. Based on the meta-analysis, outcome was in favour of the extravesical anastomosis. A relative risk (RR) for stenosis of 0.67 (confidence interval (CI), 0.48-0.93; p = 0.02), for leakage 0.55 (CI 0.39-0.80; p = 0.001) for the total number of urological complications 0.56 (CI 0.41-0.76; p < 0.001) and for haematuria of 0.41 (CI 0.22-0.76; p = 0.005) was demonstrated. Based on our results, we conclude that there is evidence in favour of the extravesical ureteroneocystostomy for having a smaller amount of urological complications in kidney transplantation.

Original languageEnglish
Pages (from-to)1179-1184
Number of pages6
JournalTransplantation
Volume94
Issue number12
DOIs
Publication statusPublished - 27 Dec 2012

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