Ron Shapiro, MD

Disclosures

December 30, 2002

Question

I have a 34-year-old female patient who underwent kidney transplantation 2 months ago. She had good graft function, but continued to have a significant drainage via the drainage tube. The tube was retained and Betadine was instilled daily. Drainage is almost nil if the urine catheter is in place, but the drainage increases if the catheter is removed. A temporary ureteric stent has been placed. Is surgery indicated?

M.S. Amaresan, MD, DM

Response from Ron Shapiro, MD

The scenario here is a bit obscure, but it sounds like a urine leak. It would be worth checking a creatinine on the drainage fluid to confirm this. If the creatinine of the fluid is greater than the serum creatinine, then there is a leak. Often urine leaks will respond to 6 weeks of urinary catheter decompression, particularly if a stent is in place; but if this has been tried and there is still a urine leak, then reoperation would be indicated, either to reimplant the ureter or, more likely in this situation, to perform a ureteroureterostomy to the native ureter.

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