Kidney transplantation into patients with abnormal bladders.

Area of Science:

• Urology
• Nephrology
• Transplantation Surgery

Background:

• A normal urinary bladder maintains low-pressure urine storage and complete emptying.
• Abnormal bladders present challenges due to high-pressure storage, leakage, or incomplete voiding.
• Historically, abnormal bladders were a contraindication for renal transplantation.

Purpose of the Study:

• To review surgical procedures for modifying abnormal bladders into continent, low-pressure reservoirs.
• To emphasize the importance of understanding these bladder modifications for successful renal transplantation.
• To demonstrate that patients with abnormal bladders can achieve outcomes comparable to those with normal bladders post-transplantation.

Main Methods:

• Review of established and novel surgical techniques for bladder reconstruction.
• Analysis of patient management strategies following bladder modification and renal transplantation.
• Evaluation of transplant outcomes in patients with surgically corrected abnormal bladders.

Main Results:

• Various surgical procedures effectively convert abnormal bladders into functional, low-pressure reservoirs.
• Successful renal transplantation is achievable in patients with previously abnormal bladders.
• Outcomes in these patients approach or match those seen in patients with normal bladders.

Conclusions:

• Abnormal urinary bladders are not absolute contraindications for renal transplantation.
• Surgical reconstruction of the bladder is key to managing these patients.
• Renal transplantation in patients with modified bladders offers favorable long-term results.