Postrenal Transplant Urethral Kock Pouch

Shokeir, Ahmed A.; Shamaa, Mostafa A.; Abol-Enien, H.; El-Mekresh, Mohsen; Ghoneim, Mohamed A.

doi:10.3109/00365599409181288

Cited by 11 publications

(5 citation statements)

References 14 publications

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“…The first orthotopic continent diversion in a man has been reported in 1994 by Shokeir et al. (urethral Kock pouch) [6], while Colombo et al. in 1997 reported the first orthotopic ileal neobladder in a woman [7], 9 and 8 years after kidney transplantation, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The published series of radical cystectomy with orthotopic neobladder in kidney transplant recipients together with our experience are reported in Table 3 [2,3,[6][7][8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…So far, twenty cases have been described in the literature and many reports of orthotopic neobladder in renal transplant recipient showed good functional outcomes. The first orthotopic continent diversion in a man has been reported in 1994 by Shokeir et al (urethral Kock pouch) [6], while Colombo et al in 1997 reported the first orthotopic ileal neobladder in a woman [7], 9 and 8 years after kidney transplantation, respectively. Both Table 3.…”

Section: Discussionmentioning

confidence: 99%

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Orthotopic bladder substitute in renal transplant recipients: experience with Studer technique and literature review

Manassero¹,

Paola²,

Mogorovich³

et al. 2011

Transplant International

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Summary Renal transplant recipients with high‐risk bladder cancer following cystectomy need a urinary diversion preserving the renal function and possibly maintaining body image, while still offering the best oncological outcome. The aim of this report is to describe our experience of radical cystectomy and orthotopic ileal neobladder with Studer technique in this population, and to review the literature. We performed radical cystectomy and Studer ileal neobladder in four male patients (median age 67 years) after median time of 9.5 years following renal transplantation. Pathology revealed pT1HGN+ transitional cell carcinoma in one case, pT1HGN0 in two and pT3aHGN0 in one. Two patients presenting aggressive disease (N+ and pT3a) died of tumour progression after 20 and 14 months, respectively, while the other two are alive after 56 and 36 months of follow‐up with no evidence of disease, stable serum creatinine (2.29 and 1.6 mg/dl) and mild metabolic acidosis. Day and night‐time urinary continence were satisfactory in all patients. Good functional outcomes have been reported in the 20 cases of ileal orthotopic neobladder with different techniques published so far and the global experience of 24 cases with a median follow‐up of 39 months documents a cancer specific survival of 62.5%.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Orthotopic bladder substitute in renal transplant recipients: experience with Studer technique and literature review

Manassero¹,

Paola²,

Mogorovich³

et al. 2011

Transplant International

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“…Therefore, the fashioning of an orthotopic ileal neobladder in a renal transplant patient can be recommended when cystectomy is required, since, according to our experience and that of others [4, 5,7,8,91, it proved to be feasible, safe (thanks to the improved quality of suture materials) and adequate to preserve graft function. There are several ways of making a detubularized ileal neobladder, but Studer technique, which assures an intact afferent ileal loop, is particularly suitable for tract reconstruction following renal transplantation, since this loop can be anastomosed to the short graft ureter, and its preserved peristalsis prevents reflux and hydronephrosis.…”

Section: Discussionmentioning

confidence: 99%

“…This risk is greatly reduced with an ileal neobladder. After a followup of 8 years, only 3% to 18% of the patients evaluated [4,5,7,8,91.…”

Section: Discussionmentioning

confidence: 99%

Cystectomy and orthotopic ileal neobladder in a male patient 12 years after kidney transplantation; good preservation of the renal function

Selli¹,

Boggi²,

Travaglini³

et al. 2004

Transplant Int

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In case of cystectomy, some forms of urinary diversion can impair the graft function of renal transplant patients. Here we present the case of a 70-year-old male with carcinoma of the bladder 12 years after renal transplantation. Immunosuppression was achieved with Cyclosporin A (200 mg/day) and Prednisone (5 mg/day). The patient's serum creatinine level was 1.4 mg/dl. Following cystectomy, an orthotopic ileal neobladder was constructed by means of Studer technique, and the afferent ileal loop was anastomosed to the graft ureter.Pathology revealed pT1 G3 N + transitional cell carcinoma. Ten months later, periaortic nodal recurrences necessitated four cycles of chemotherapy with Epidoxorubicyn and Gemcytabine. To date, 20 months after cystectomy, the patient is stable, with day and nighttime urinary continence. His serum creatinine level is 1.3 mg/dl, and there is no evidence of hydronephrosis or acidosis. We conclude that the orthotopic ileal neobladder is an effective form of urinary diversion in renal transplant patients requiring cystectomy, allowing good preservation of the renal function. Keywords Kidney transplantationBladder neoplasms . Urinary diversion Abbreviations BCG Bacillus Calmette GulrinImmunosuppression following renal transplantation increases the risk of tumor development, including that of bladder carcinoma [l]. Radical cystectomy may be necessary in these patients, however, some forms of urinary diversion, such as an ileal conduit, may impair graft function. Here we report the case of an orthotopic ileal neobladder allowing good preservation of renal function in a renal transplant patient. Case reportThe patient, a 70-year-old male, had undergone cadaveric kidney transplantation 12 years previously. The graft, with a cold ischemia time of 14 h, was from a 15-year-old female donor of identical haplotype.The initial immunosuppressive regimen was Cylosporine A (CSA) 230 mg/day, Azathioprine 50 mg/day and Prednisone 15 mg/day. Due to patient age, the immunosupperessive regimen was tapered over the years to CSA 200 mg/day and Prednisone 5 mg/day. The graft was functioning well with a serum creatinine level of 1.4 mg/dl. During the previous year, two transurethral superficial bladder tumors had been resected, and a recent third resection revealed pT1 G3 transitional cell carcinoma. Spiral CT scan failed to demonstrate enlarged pelvic lymph nodes and showed two shrunken native kidneys, the chest X-ray was normal.The patient underwent radical cystectomy with right-sided pelvic lymphadenectomy, since the graft was placed in the left iliac fossa. An ileal orthotopic neobladder was fashioned by means of Studer technique using 55 cm of the terminal ileum, which was detubularized and folded twice, leaving a 14 cm afferent ileal loop, which was anastomosed to the graft ureter in the left iliac fossa by means of the "split cuff' technique (Fig. 1). The postoperative

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Cystectomy and orthotopic ileal neobladder in a male patient 12�years after kidney transplantation; good preservation of the renal function

Selli¹,

Boggi²,

Travaglini³

et al. 2004

Transplant International

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Postrenal Transplant Urethral Kock Pouch

Cited by 11 publications

References 14 publications

Orthotopic bladder substitute in renal transplant recipients: experience with Studer technique and literature review

Orthotopic bladder substitute in renal transplant recipients: experience with Studer technique and literature review

Cystectomy and orthotopic ileal neobladder in a male patient 12 years after kidney transplantation; good preservation of the renal function

Cystectomy and orthotopic ileal neobladder in a male patient 12�years after kidney transplantation; good preservation of the renal function

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