Our Summary

This research paper discusses kidney transplants for patients with altered urinary systems, which is a difficult process. Earlier research suggested that kidney transplants in these patients were not very successful. However, more recent studies have shown that despite an increased risk of infection, these patients’ new kidneys can survive just as long as those in patients with normal urinary systems. Therefore, it’s very important to thoroughly check these patients before surgery. Special techniques and surgical plans must be thought out before performing a kidney transplant in this group of patients.

FAQs

  1. What is urinary diversion surgery and how does it relate to renal transplantation?
  2. What are the potential complications of kidney transplantation in patients with urinary diversion?
  3. What is the importance of preoperative assessment in patients with urinary diversions undergoing kidney transplantation?

Doctor’s Tip

One helpful tip a doctor might tell a patient about urinary diversion surgery is to carefully follow the post-operative instructions provided by the medical team. This may include proper wound care, monitoring for signs of infection, and adhering to any dietary or lifestyle changes recommended to optimize recovery and minimize complications. Additionally, it is important to attend all follow-up appointments with your healthcare provider to ensure the best possible outcome.

Suitable For

Patients who may be recommended for urinary diversion surgery include those with:

  1. Bladder cancer requiring radical cystectomy and urinary diversion
  2. Neurogenic bladder dysfunction, such as spinal cord injury or spina bifida
  3. Chronic bladder dysfunction, such as interstitial cystitis or bladder exstrophy
  4. Severe bladder outlet obstruction
  5. Recurrent urinary tract infections or incontinence that cannot be managed with conservative treatments

It is important for these patients to undergo a thorough evaluation by a urologist and/or transplant surgeon to determine the most appropriate surgical approach and ensure that they are suitable candidates for urinary diversion surgery.

Timeline

Before urinary diversion surgery:

  • Patient is diagnosed with a condition that requires urinary diversion, such as bladder cancer or neurogenic bladder dysfunction.
  • Patient undergoes preoperative evaluations and tests to assess their overall health and suitability for surgery.
  • Patient meets with a urologist and/or a surgeon to discuss the procedure, potential risks, and postoperative care.

After urinary diversion surgery:

  • Patient undergoes the surgical procedure to create the urinary diversion, which may involve creating a stoma or rerouting the urinary tract.
  • Patient stays in the hospital for a period of time to recover from surgery and learn how to care for their new urinary system.
  • Patient may experience temporary discomfort, pain, or complications after surgery, which will be managed by the medical team.
  • Patient will need to follow up with their healthcare provider regularly to monitor their urinary function, address any issues, and ensure proper healing.
  • Over time, the patient will adjust to life with a urinary diversion and should be able to resume normal activities with proper care and management.

What to Ask Your Doctor

  1. How will urinary diversion surgery affect my eligibility for renal transplantation?
  2. What are the risks and potential complications associated with renal transplantation in patients with urinary diversion?
  3. How will my current urinary reservoir affect the surgical procedure for renal transplantation?
  4. Will I require any additional preoperative testing or evaluation due to my urinary diversion?
  5. How will my postoperative care and follow-up differ from patients with native anatomy?
  6. What are the long-term outcomes and success rates for renal transplantation in patients with urinary diversion?
  7. Are there any specific lifestyle changes or considerations I should be aware of following renal transplantation with urinary diversion?
  8. How experienced is the medical team in performing renal transplantation in patients with urinary diversion?
  9. Are there any alternative treatment options or considerations I should be aware of before proceeding with renal transplantation?
  10. What are the potential benefits and advantages of undergoing renal transplantation with urinary diversion in my specific case?

Reference

Authors: Eltemamy M, Crane A, Goldfarb DA. Journal: Urol Clin North Am. 2018 Feb;45(1):113-121. doi: 10.1016/j.ucl.2017.09.012. PMID: 29169444