An abnormal urinary bladder is no longer a contra-indication to renal transplantation. A normal urinary bladder stores urine at low pressure, does not leak, and empties completely by natural voiding. In contrast, an abnormal urinary bladder stores urine at high pressure, leaks, or does not empty completely by natural voiding. A variety of procedures have been devised to change the abnormal bladder into a continent low-pressure reservoir. Knowledge of these bladder modifications and their management should allow successful transplantation in patients with abnormal bladders and provide outcomes that match or approach those achieved in patients with a normal bladder.
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