Laparoscopic ureterocystoplasty before kidney transplantation.
OBJECTIVE
To describe the technique of total laparoscopic ureterocystoplasty.


METHODS
Laparoscopic ureterocystoplasty was performed to optimize the bladder function before kidney transplantation in a 23-year-old man. This patient had undergone bilateral cutaneous ureterostomy with fulguration of a posterior urethral valve at the age of 11 months. He underwent open surgical removal of multiple renal stones at age 10. He progressed to chronic renal failure at the age of 20, at which time hemodialysis was initiated. Because of grade IV vesicoureteral reflux and a poorly compliant bladder, the patient underwent laparoscopic ureterocystoplasty.


RESULTS
The patient's lower urinary tract symptoms improved, and a urodynamic study performed after 6 months revealed a compliant bladder. Subsequently, a right nephrectomy and a live-donor renal transplantation from his mother were performed. At 1-year follow-up, his renal parameters were within normal range, he does not have any significant residual urine or urinary symptoms.


CONCLUSIONS
Laparoscopic ureterocystoplasty is an excellent option for a poorly compliant bladder, especially when a patient has had multiple open surgeries and is awaiting renal transplantation.
Ramalingam
Manickam
M
Department of Urology, K.G. Hospital and Post Graduate Institute, Coimbatore, India. uroram@yahoo.com
Senthil
Kallappan
K
Pai
Mizar G
MG
Balasubramanian
Raju
R
Premkumar
Krishnasamy
K
D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery; D016030:Kidney Transplantation; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014563:Urodynamics; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000503:physiopathology / Q000601:surgery*