title: Orthotopic ileal neobladder reconstruction in patients with bladder cancer following renal transplantation.
abstract: OBJECTIVE
  We analyzed the safety and clinical outcome in a single institution experience with orthotopic ileal neobladder reconstruction following radical cystectomy for transitional cell carcinoma in renal transplant recipients.
  
  
  METHODS
  From April 1986 to December 2003 radical cystectomy and orthotopic ileal neobladder reconstruction were performed in 760 consecutive patients with bladder cancer, of whom 4 had bladder cancer a median of 10.5 years after renal transplantation. The postoperative clinical course and long-term results in these patients were reviewed.
  
  
  RESULTS
  Median followup after surgery was 51.5 months (range 11 to 118). Two patients died at 11 and 15 months of tumor progression and a pulmonary embolism, respectively, whereas 2 were alive at a mean followup of 90 months with no evidence of disease. No neobladder related reoperations were necessary. Serum creatinine as a marker of renal function was stable in 3 patients. In 1 patient chronic graft rejection led to progressive renal failure and hemodialysis. Urinary continence was satisfactory during the day and night with spontaneous voiding in all patients and no significant post-void residual urine.
  
  
  CONCLUSIONS
  To our knowledge this is the largest reported series of orthotopic ileal neobladder replacement following radical cystectomy in renal transplant recipients. Our results demonstrate the feasibility of radical cystectomy and orthotopic urinary reconstruction in patients with a renal transplant who have good functional and oncological results despite the high comorbidity in this group.
authors.affiliation: Department of Urology, University of Ulm, Heidenheim, Germany.
authors.forename: Herve
authors.initials: H
authors.lastname: Lang
authors.forename: Robert
authors.initials: R
authors.lastname: de Petriconi
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wenderoth
authors.forename: Bjoern G
authors.initials: BG
authors.lastname: Volkmer
authors.forename: Richard E
authors.initials: RE
authors.lastname: Hautmann
authors.forename: Juergen E
authors.initials: JE
authors.lastname: Gschwend
mesh_terms: D000328:Adult; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D015653:Cystectomy; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods