OUTCOMES OF AUGMENTATION CYSTOPLASTY PRIOR TO RENAL TRANSPLANTATION: A RETROSPECTIVE CASE SERIES

Document Type

Conference Proceeding

Publication Date

2-28-2026

Publication Title

Neurourol Urodyn

Keywords

botulinum toxin, adult, aged, bladder augmentation, bladder capacity, bladder compliance, bladder dysfunction, bladder pressure, bladder reconstruction, case report, case study, clinical article, complication, conference abstract, cystoscopy, drug combination, drug therapy, end stage renal disease, estimated glomerular filtration rate, female, follow up, graft failure, human, hypertension, ileocystoplasty, kidney allograft, kidney graft, kidney transplantation, male, obstructive uropathy, pyelonephritis, reflux nephropathy, retrospective study, surgery, therapy, urinary tract function, urinary tract infection, urodynamics, vesicoureteral reflux

Abstract

Introduction: Augmentation cystoplasty increases bladder capacity and reduces intravesical pressure in patients with compromised lower urinary tract function. In patients with end stage renal disease (ESRD), bladder dysfunction can pose a significant risk of complications following renal transplantation, including reflux nephropathy and graft failure. Performing an augmentation cystoplasty prior to renal transplantation in select patients aims to improve bladder compliance and ultimately, renal allograft outcomes. Methods: This case series includes two patients with ESRD who underwent augmentation cystoplasty prior to renal transplantation. Case 1: A 39‐year‐old female was referred to the clinic with history of ESRD secondary to obstructive uropathy. Workup was initiated with fluoroscopic urodynamics and cystoscopy which revealed a bladder capacity of 550cc and compliance of 10.25 cc/cm H2O with grade III right vesicoureteral reflux. Her compliance did not improve with anticholinergics or intradetrusor botulinum toxin. She underwent an uncomplicated augmentation ileocystoplasty and her compliance improved to 200cc/cm H2O post‐operatively. She received a renal transplant 1 year after bladder augmentation. Case 2: A 64‐year‐old male was referred to the clinic with history of ESRD secondary to hypertension. Pre‐transplant clearance workup with fluoroscopic urodynamics revealed a reduced bladder capacity of 125cc and compliance of 9cc/cm H2O. His parameters did not improve with intradetrusor botulinum toxin. He underwent an uncomplicated augmentation ileocystoplasty and his bladder capacity increased to 450cc post‐operatively. He received a renal transplant 4 months afterward. Results: Case 1: The patient returned for follow up in the urology clinic at 1, 3, and 4 year intervals post‐transplant with stable estimated glomerular filtration rate (eGFR) > 50 at each visit. She had occasional urinary tract infections without ascending graft pyelonephritis. Case 2: The patient returned for regular follow up in the urology clinic and at 2‐years post-transplant his graft is functioning well with an eGFR > 70 and no augment‐related complications. Conclusions: Augmentation cystoplasty prior to renal transplantation in patients with low bladder capacity and poor compliance is a safe and effective way to optimize postoperative graft outcomes. This case series suggests that bladder reconstruction may be considered in select patients to allow clearance for renal transplantation.

Volume

45

First Page

S121

Find It @ Sladen

Share

COinS