[A CASE OF REFRACTORY BLADDER HEMORRHAGE AFTER GASTROCYSTOPLASTY].

Abstract

A 34-year-old man had undergone living donor kidney transplantation for hypoplastic and dysplastic kidney and gastrocystoplasty and umbilical-urinary tract reconstruction using the appendix for contracted bladder in his early childhood. At the age of 19 years, renal transplant function was lost, and hemodialysis was thus initiated. Since then, he had regularly visited our department while continuing to perform urethral self-catheterization and self-bladder irrigation to alleviate bladder irritation symptoms due to hematuria-dysuria syndrome. Subsequently, the patient experienced hemorrhage from the bladder augmented with the stomach, which led to the development of bladder tamponade and the progression of anemia. He was thus admitted to our department and received continuous bladder irrigation and other conservative therapies, as well as vascular embolization. Because hemostasis was not achieved despite these procedures, partial cystectomy (resection of the bladder augmented with the stomach) was performed. Here, we report our experience with a patient with refractory bladder hemorrhage due to hematuria-dysuria syndrome, for which we performed partial cystectomy and achieved hemostasis. Although gastrocystoplasty has been rarely performed in recent years because of specific postoperative complications such as hematuria-dysuria syndrome, caution should be exercised in patients with anuria due to renal failure or other causes.