Abstract
Congenital or acquired dysfunction of the lower urinary tract may result in renal failure. In this group of patients urinary diversion or lower urinary tract reconstruction is mandatory prior to renal transplantation. Avoiding creation of an external stoma offers far more better quality of life to these unfortunate patients.
We present three patients in end-stage renal disease. Two of them presented with dysfunction of the lower urinary tract and the third with absence of the bladder. Reconstruction or substitution of their bladders has been performed prior to kidney transplantation. In one patient an artificial urinary sphincter was implanted simultaneously in order to achieve continence, while all the patients have to empty their neobladders or augmented bladders by clean intermittent self-catheterization.
In conclusion, dysfunction or absence of the lower urinary tract does not preclude renal transplantation and however abnormal the urinary tract, transplantation can still be performed if low-pressure, high-compliance reservoir can be achieved by means of augmentation or substitution cystoplasty.
Similar content being viewed by others
References
Beyton, D., Vu, Ph., Gonties, D., Ewald, N., Terdjman, S.: L'utilization du greffon intestinal dans la transplantation rénale chez l'enfant et l'adulte.J. Urol. (Paris), 92, 605 (1986).
Flood, H. D., Malhotra, S. J., O'Connell, H. E., Ritchey, M. J., Bloom, D. A., McGuire, E. J.: Long-term results and complications using augmentation cystoplasty in reconstructive urology.Neurol. Urodyn., 14, 297 (1995).
Gelet, A., Sanseverino, R., Salas, M., Martin, X., Marechal, J. M., Duberard, J. M.: The AS 800 urinary sphincter in renal transplantation.Br. J. Urol., 66, 549 (1990).
Gill, I. S., Hayes, J. M., Hodge, E. E., Novick, C.: Clean intermittent self catheterisation and urinary diversion in the management of renal transplant recipients with lower urinary tract dysfunction.J. Urol., 148, 1377 (1992).
Lilien, O. M.: Commentary and critique of Maurice Kamey's enterocystoplasty.Urol. Clin. N. Amer., 13 (2), 345 (1986).
Hautmann, R. E., Egghart, G., Frohneberg, D., Miller, K.: The ilial neobladder.J. Urol., 139, 39 (1988).
Kelly, W. D., Merkel, F. K., Markland, C.: Renal urinary diversion in conjunction with renal homotransplantation.Lancet, 1, 222 (1966).
Kock, N. G., Nilsson, A. E., Nilsson, L. O.: Urinary diversion via a continent ileal reservoir: Clinical results in 12 patients.J. Urol., 128, 469 (1982).
Glass, N. L., Vehline, D., Sollinger, H., Belzer, F.: Renal transplantation using ileal conduits in 5 cases.J. Urol., 133, 666 (1985).
Marechal, J. M., Sanseverino, R., Gelet, A., Martin, X., Salas, M., Dubernard, J. M.: Continent cutaneous ileostomy (Kock pouch) prior to renal transplantation.Br. J. Urol., 65, 317 (1990).
McInerney, P. D., Picramenos, D., Koffman, C. G., Mundy, A. R.: Is cystoplasty a safe alternative to urinary diversion in patients requiring renal transplantation?Eur. Urol., 27, 117 (1995).
Mundy, A. R.: Cystoplasty. In Mundy, A. R., Stephenson, T. P., Wein, A. (eds): Urodynamics: Principles, Practice and Application. 2nd Edition. Churchill-Livingstone, London 1994, pp. 457–466.
Skinner, D. G., Lieskovsky, G., Boyd, S. D.: Technique of creation of a continent internal ileal reservoir (Kock pouch) for urinary diversion.Urol. Clin. N. Amer., 11, 741 (1984).
Studer, U. E., Casanova, G. A., Ackermann, D. K., Zingg, E. Z.: Ileal bladder substitution: Antireflux nipple or afferent tubular segment.J. Urol., 143 (Suppl.), 398A (1990).
Thomalla, J. V., Mitchell, M. E., Leapman, S. B., Filo, R. S.: Renal transplantation in a patient with an artificial sphincter device.J. Urol., 139, 573 (1988).
Woodhouse, C. R. J.: Transplantation with abnormal lower urinary tracts. In: Woodhouse, C. R. J. (ed.): Long-term Paediatric Urology. Blackwell, London 1991, p. 35.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Theodorou, C., Kostakis, A., Bokos, J. et al. Lower urinary tract reconstruction in association with renal transplantation. International Urology and Nephrology 29, 695–699 (1997). https://doi.org/10.1007/BF02552188
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02552188