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Transplantation into the long-term defunctionalized bladder

D P Serrano1, S M Flechner, C S Modlin

  • 1Department of Urology, Cleveland Clinic Foundation, Ohio, USA.

The Journal of Urology
|September 1, 1996
PubMed
Summary
This summary is machine-generated.

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Renal transplantation into a long-term defunctionalized bladder is safe for select patients. Pre-transplant evaluation of bladder function and continence through rehabilitation is crucial for successful outcomes.

Area of Science:

  • Urology
  • Nephrology
  • Transplantation Surgery

Background:

  • Long-term defunctionalized bladders pose unique challenges for renal transplantation.
  • Assessing pre-existing bladder capacity and continence is vital before considering such procedures.

Purpose of the Study:

  • To evaluate the outcomes of renal allograft transplantation into a long-term defunctionalized bladder.
  • To determine the safety and efficacy of this approach in carefully selected patients.

Main Methods:

  • Transplantation was performed in 5 patients with defunctionalized bladders (15-26 years).
  • Pre-transplant evaluation included cystoscopy, voiding cystography, urodynamics, and continence assessment.
  • Bladder rehabilitation involved suprapubic tube or urethral catheter cycling; no augmentation was performed.

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  • Patients received long-term antibiotic prophylaxis.

    • Main Results:

    • All 5 patients remained alive with functioning allografts at 6 to 120 months post-transplant.
    • Significant improvements in median urodynamic parameters were observed: bladder capacity increased from 60 to 300 cc, peak flow rate from 5 to 18 cc/sec.
    • Post-void residual volume decreased from 20 to 15 cc.
    • One patient required intermittent self-catheterization.

    Conclusions:

    • Renal transplantation into a long-term defunctionalized bladder is a viable and safe option for select individuals.
    • Thorough pre-transplant assessment of bladder function and continence, coupled with a progressive bladder rehabilitation program, is essential for success.