[Restoration of urinary tract continuity in a non-functioning bladder after renal transplantation]

The restoration of the continuity of the urinary tract after renal transplantation in anuric patients, an increasingly frequent situation, raises a number of theoretical problems: is it possible to use a bladder which has been non-functioning, sometimes for many years (20 years)? What should be performed during pre-operative assessment? Which surgical technique should be used? The authors try to answer these questions on the basis of their experience of 116 transplanted anuric patients. Anuria, even of long duration, does not prevent the use of the bladder, provided that the bladder was originally normal and is not infected. The pre-operative assessment is the same as for other patients and urodynamic investigations are not required. The optimal reimplantation technique is the Leadbetter-Politano open bladder technique and every effort should be made to obtain abundant diuresis immediately. Under these conditions, reimplantation into these non-functioning bladders is not associated with more complications than in the case of normal bladders.