الفهرس 
Introduction & Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
Renal transplantation is the treatment of choice of end-stage renal disease by providing more cost effective than hemodialysis with a lower morbidity and better quality of life. Urological complications are major contributors to the morbidity associated with renal transplantation. These problems may lead to graft loss. Improved protection of ureteral vessels, use of shorter transplant ureters and better preservation of priureteral fat have all helped to reduce these problems. The reported incidence of urological complications following renal transplantation in large series is 2.6-15%. These complications include ureteral obstruction (either intrinsic or extrinsic), urine leakage, urolithiasis and others. Initial management of obstructed ureters by percutaneous nephrostomy tube fixation may improve graft survival and provide better access for diagnosis and intervention. Regardless the technique of management of ureteral stricture, postoperative ureteral stenting for 6-8 week is mandatory. Minimal urinary leakage is encouraging factor for applying conservative treatment by catheter prolongation in case of vesical leakage or percutaneous nephrostomy tube fixation with or without ureteral stent for ureteral leakage, otherwise early open surgical reconstruction is recommended. Endoscopic intraureteral or subureteral injection of bulking agents seems to be a good alternative treatment to correct post transplant vesicoureteral reflux. Allograft nephrolithiasis is uncommon complication following renal transplantation. Graft stones may be donor-gifted or denovo-developed. A donor with history of stone disease is suitable for donation if he does not have any risk factors of recurrent stones. If the donor has a stone, he is accepted for donation if stone is less than 1.5 cm and is liable for removal during transplantation. Prior to renal transplantation ex-vivo removal of graft stone is a viable option putting in consideration the possibility to injury the ureter-pelvicalyceal system and increase in cold ischemia time. In the transplanted kidneys, for stones less than 5 mm, a watchful waiting strategy is optimal unless there is no obstruction. For 5 to 15 mm stones, shockwave lithotripsy is feasible; however, a percutaneous nephrostomy tube or double J coverage is preferred in obstructed systems. Percutaneous nephrolithotomy and antegrade ureteroscopy is the management of choice for bigger stone burden with special care to avoid bleeding and bowel injury. Lymphocele is a common pathology after a renal transplantation which needs to be treated depending on its clinical manifestations. There mainly are two therapeutic alternatives depending on the size of the lymphocele, sclerotherapy and surgical intraperitoneal drainage. Laparoscopic approach is currently considered, because of its security and effectiveness, the first choice when a surgical treatment is prescribed.