RENAL-TRANSPLANTATION INTO THE DYSFUNCTIONAL BLADDER - THE ROLE OF ADJUNCTIVE BLADDER RECONSTRUCTION

retrospective review of pediatric renal transplantation at 3 centers i dentified 9 patients who had undergone major bladder reconstruction. S even patients underwent bladder augmentation (5 gastric, 1 colonic, 1 ureteral) and 2 received gastric neobladders. Six patients required Mi trofanoff neourethras. Patient survival was 100% with initial graft su rvival of 56% during a mean followup of 29.4 months. Eight patients (8 9%) are presently dialysis-free with functioning allografts and all 9 (100%) are continent of urine. We conclude that renal transplantation and reconstruction to ensure continence are justifiable in even the mo st anatomically compromised children with end stage renal disease. It is essential that the pediatric urologist should have an integral role in the management of such cases.