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Updated: Apr 28, 2026
Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
Published on: August 9, 2012
Renal transplantation in augmented bladders
P López Pereira1, M J Martínez Urrutia, R Lobato
1Department of Paediatric Urology, University Hospital "La Paz", Pº de la Castellana 261, Madrid, 28046, Spain, plpuro@hotmail.com.
Insights
Pediatric renal transplantation is now successful in children with bladder dysfunction using augmentation cystoplasty (AC). This procedure creates a functional bladder reservoir, improving graft survival rates despite potential urinary tract infection risks.
Area of Science:
- Pediatric Urology
- Transplantation Surgery
- Nephrology
Background:
- Children with lower urinary tract abnormalities or bladder dysfunction were historically high-risk for renal transplantation.
- Poorly compliant, low-capacity bladders posed significant challenges to successful kidney graft outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of augmentation cystoplasty (AC) in pediatric renal transplant recipients with bladder dysfunction.
- To assess the impact of AC on graft survival, function, and complication rates.
Main Methods:
- Review of outcomes in pediatric patients who underwent renal transplantation with concurrent augmentation cystoplasty.
- Comparison of graft survival, function, and complication rates (e.g., UTIs) between patients with and without AC.
Main Results:
- Augmentation cystoplasty creates a compliant, low-pressure reservoir, preserving kidney grafts in children with bladder dysfunction.
- Urinary tract infections (UTIs) in AC patients are often linked to catheterization noncompliance or vesicoureteral reflux, not the AC itself, and typically do not impair graft function.
- Pediatric renal transplant recipients with AC achieve similar graft survival and function outcomes as those with normal bladders.
Conclusions:
- Augmentation cystoplasty is a viable and effective procedure for pediatric renal transplant recipients with bladder abnormalities.
- While UTIs can occur, they are manageable and do not negate the benefits of AC for graft preservation.
- Long-term monitoring for potential malignant transformation in the augmented intestinal segment is warranted.
Abstract:
Not many years ago, children with congenital abnormalities of the lower urinary tract or with bladder dysfunction were denied renal transplantation because they were considered very high-risk recipients. However, in the past few decades, we learned that in children with poorly compliant, low-capacity bladders, augmentation cystoplasty (AC) can create a compliant, low-pressure reservoir that helps preserve the kidney graft. Although the incidence of symptomatic urinary tract infection (UTI) may be greater in pediatric transplant recipients with an AC than in those without, UTI is related more to noncompliance with clean intermittent catheterization or vesicoureteral reflux to the native kidney or graft than to the AC itself, and usually does not lead to impairment of graft function. Today, children with a bladder reconstruction may undergo transplantation with the same outcome (graft survival and function) as those with normal bladders, although there is some possibility of malignant transformation in the intestinal segment used to augment the bladder in these patients.
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