Objective   To investigate the therapeutic strategies for urinary fistula after renal transplantation.

  Methods   Among the 1 228 patients who received allogenic renal transplantation in Institute of Organ Transplantation, the 309^th Hospital of Chinese People's Liberation Army from June 2008 to December 2012, clinical data of 72 patients with urinary fistula after renal transplantation were analyzed retrospectively.

  Results   The incidence of urinary fistula in this group was 5.86%. After the patients were diagnosed, the ureteral stents were kept indwelled firstly by the way of keeping Foley catheter. Common catheter or Latex tube were placed in the original wound or drainage outlet for drainage when the above therapy was ineffective. Surgical treatment was performed at last and tension-free anastomosis was taken. Among the 72 patients with urinary fistula, 46 cases were cured by conservative treatment. And 26 cases received surgical treatment after failed conservative treatment, in which 12 cases received repairment of fistula and placement of Foley catheter in the bladder, 10 cases were cured after receiving ureter-bladder anastomosis+ureteral stent placement, and 4 cases were cured by receiving autologous ureter-transplant kidney ureter anastomosis after failure of ureter-bladder muscle flap anastomosis. Two cases suffered from partial wound infection and were cured after enhancing drainage and anti-infective therapy.

  Conclusions   Prevention is prior to treatment for urinary fistula after renal transplantation. The key to successful treatment is early diagnosis and proper choice of therapy. Once the diagnosis is confirmed, conservative treatment is given preferentially, then surgical treatment is taken when the conservative treatment is failed. The principle of tension-free anastomosis should be followed.