RESUMO
OBJECTIVES: To evaluate kidney graft response and survival in patients with anomalies of the lower urinary tract from the perspective of the type urinary diversion performed or cystoplasty. METHODS: 7 patients with anomalies of the urinary tract who underwent kidney transplantation a described and the literature reviewed. RESULTS: In one patient who received an orthotopic kidney, urinary diversion to a preexisting ileal neobladder was performed. In 6 patients cutaneo ureterostomy was decided at the time of transplantation to resolve urinary drainage initially. The scant morbidity and good functional results of the grafts have momentarily delayed reconversion to another type of diversion in some cases. The literature review has shown that in recent years most authors with significant series have advocated preservation and reconstruction of the recipient's bladder and, if not feasible, continent external diversion. CONCLUSIONS: Anomalies of the lower urinary tract do not preclude renal transplantation in these patients. A detailed study of the uropathy, including urodynamic evaluation, is required prior to transplantation. Bladder preservation and refunctionalization are desirable, but if not feasible, transintestinal suprapubic diversion should be considered.
