Enterocystoplasty and renal transplantation

Abstract

Purpose: We report on our experience with renal transplantation in patients with severe chronic bladder contracture who underwent prior intestinal bladder augmentation, and assess the safety of the procedure.

Materials and methods: A total of 7 patients with severe alterations to the lower urinary tract and renal insufficiency underwent enterocystoplasty before renal transplantation. The etiologies of the bladder dysfunction were bladder contraction secondary to urinary tuberculosis in 4 cases, neurogenic bladder secondary to myelomeningocele in 1, chronic cystitis secondary to intravesical instillation of glutaraldehyde in 1 and hyperreflexic, contracted bladder in 1. Mean patient age was 38.4 years (range 19 to 57). The intestinal segment used was ileal conduit in 6 cases and an ileocaecal segment in 1. All 7 patients have received renal transplant from cadaveric donors.

Results: Graft survival rate was 100% and graft function was good after a mean followup of 48 months (range 8 to 97). Of the patients 6 are continent and void spontaneously and 1 requires intermittent self-catheterization.

Conclusions: In our experience bladder augmentation is an acceptable method, although not exempt from complications, for patients with alterations to the lower urinary tract and who are candidates for renal transplantation.