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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Related Experiment Video

Updated: Sep 17, 2025

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
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A Case of Intraoperative Bladder Rupture During Kidney Transplantation.

Kosuke Ogawa1, Yusuke Tabuchi1, Takahiro Yamaguchi1

  • 1Department of Urology Kyoto Katsura Hospital Kyoto Japan.

IJU Case Reports
|July 3, 2025
PubMed
Summary

Bladder rupture is a rare kidney transplant complication, especially in patients with low-compliance bladders. Careful management is crucial to prevent this serious issue.

Keywords:
anuriabladder atrophybladder rupturekidney transplantationureteroureterostomy

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Area of Science:

  • Nephrology
  • Urology
  • Transplant Surgery

Background:

  • Bladder rupture is an uncommon but serious complication following kidney transplantation.
  • Patients with reduced bladder compliance are at higher risk.
  • End-stage renal disease and diabetic nephropathy are common indications for kidney transplant.

Purpose of the Study:

  • To report a case of bladder rupture during kidney transplantation.
  • To highlight the management and outcomes of this rare complication.

Main Methods:

  • A case presentation of a patient undergoing ABO-incompatible living-donor kidney transplantation.
  • Surgical intervention involved repair of bladder rupture and modification of the ureteral anastomosis technique.
  • Postoperative care included bladder catheterization and monitoring of voiding function.

Main Results:

  • Bladder rupture was identified during pre-anastomosis saline injection.
  • The rupture was successfully repaired with full-thickness sutures.
  • The surgical approach was altered from ureterovesical anastomosis to ureteroureterostomy.
  • The patient experienced improved voiding after catheter removal on postoperative day 21 without complications.

Conclusions:

  • Bladder rupture during kidney transplantation, though rare, requires prompt recognition and management.
  • In patients with atrophic bladders, preventing sudden intravesical pressure increases and careful catheter handling are vital.
  • Altering surgical strategy, such as performing ureteroureterostomy, can be a successful alternative to ureterovesical anastomosis in such cases.