Absorbable and non-absorbable suture materials were evaluated for calculi formation and tissue reactivity in the rabbit bladder. Five-O chromic, polydioxinone and polypropylene sutures were used to close cystostomies made in New Zealand white rabbits. Bladders were evaluated at 15, 30, 60 and 90 days. Calculi formed on all sutures tested and the persistence of calculi appeared to be dependent on the longevity of the suture material used. This data suggests that the use of non-absorbable suture material in urologic surgery may contribute to calculus formation.

Ureteroneocystostomy was used as the primary method of urinary tract reconstruction in 282 allograft renal transplants at our center since 1965. A nonrefluxing anastomosis was incorporated whenever possible. Seven patients who suffered major urological complications involving the ureteroneocystostomy required pyeloureterostomy as the method of repair using the patient's distal native ureter. No ipsilateral nephrectomy was performed and simple ligation of the native ureter with nonabsorbable suture was accomplished. Of the 7 patients 3 suffered hydronephrosis of the native kidney. None of these patients had signs or symptoms secondary to acute and chronic ureteral occlusion. Our experience suggests that intentional ligation of the native ureter during pyeloureterostomy does not result in increased morbidity to the transplant patient, and that the need for ipsilateral nephrectomy with its own added morbidity may not be necessary.

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