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Evaluation of Biomaterials for Bladder Augmentation using Cystometric Analyses in Various Rodent Models
10:19

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Published on: August 9, 2012

Bladder augmentation can be problematic with renal failure and transplantation

E J Alfrey1, O Salvatierra, D C Tanney

  • 1Department of Surgery, Stanford University, California 94305, USA.

Pediatric Nephrology (Berlin, Germany)
|January 23, 1998
PubMed
Summary

Urinary bladder augmentation (UBA) may worsen kidney function in patients with chronic renal failure (CRF) or those awaiting transplantation. UBA takedown before kidney transplant improved outcomes for some patients, suggesting caution with UBA in these populations.

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Area of Science:

  • Urology
  • Nephrology
  • Transplantation Surgery

Background:

  • Urinary bladder augmentation (UBA) is a surgical procedure to enlarge the bladder.
  • Its use in patients with chronic renal failure (CRF) or end-stage renal disease (ESRD) requires careful consideration due to potential complications.

Purpose of the Study:

  • To evaluate the outcomes of urinary bladder augmentation (UBA) in patients with pre-existing chronic renal failure (CRF) or end-stage renal disease (ESRD).
  • To assess the impact of UBA on renal function and transplantation success in this patient cohort.

Main Methods:

  • A retrospective study of ten consecutive patients who experienced UBA failure.
  • Analysis of complications, progression to ESRD, and outcomes after UBA takedown and/or renal transplantation.

Main Results:

  • Seven patients with moderate CRF developed hydroureteronephrosis, infections, and advanced to ESRD after UBA, with a mean time of 1.8 years.
  • UBA takedown in these seven patients preceded transplantation, with five achieving stable graft function.
  • Three patients undergoing UBA after reaching ESRD for transplantation experienced recurrent urosepsis post-transplant, leading to one death and one graft loss.

Conclusions:

  • Urinary bladder augmentation may not be advisable for patients with moderate CRF or those awaiting renal transplantation.
  • Takedown of UBA prior to kidney transplantation can lead to successful graft function in selected cases.
  • UBA in patients with ESRD awaiting transplantation is associated with significant post-transplant infectious complications.