Is Pretransplant Bladder Augmentation Using Hydrostatic Pressure of Contracted Bladder in Chronic Renal Failure Really Effective? / 대한이식학회지

ABSTRACT

PURPOSE: Kidney transplantation is definite treatment in chronic renal failure (CRF). But CRF patients have contracted bladder due to disuse atrophy and fibrosis of bladder mucosa and muscle. Contracted bladder results in CRF itself and failure of transplantation. And this causes many difficulties in ureteroneocystostomy. So many authors suggest that preoperative bladder augmentations of contracted bladder (cystoplasty) using intestine increase success rate in kidney transplantation. But these methods have been usually studied in pediatric transplantation. Preoperative hydrostatic bladder dilatation is nonoperative treatment usually used in interstitial cystitis and hemorrhagic bladder tumor. METHODS: Since January 1996, we newly attempted pretransplant bladder augmentation using hydrostatic pressure in 22 CRF patients who had contracted bladder diagnosed through preoperative voiding cystourethrogram (VCUG). RESULTS: Pre-augmented average bladder volume was 87.7 mL (60~100 mL) and post-augmented bladder volume was 210.5 mL (100~250 mL). There was no complication associated with pretransplant bladder augmentation itself, and there was no transplanted kidney loss. CONCLUSION: These results suggest that pretransplant bladder augmentation using hydrostatic pressure be useful in kidney transplantation of CRF patient who had contracted bladder.