Renal transplantation in children with occult neurogenic bladders drained by intermittent self catheterisation.

Children with neurogenic bladders have usually not been considered for renal transplantation because of the potential complications caused by chronic infections of the urinary tract. Two girls with occult neurogenic bladders who were practising intermittent self catheterisation were given renal transplants. Both took prophylactic antibacterial agents after transplantation, and both experienced infections at some stage, but none of these infections produced a deterioration in renal function. In one patient creatinine clearance fell and signs of obstruction appeared, but this was because the patient had been catheterising herself only two or three times a week. When she resumed catheterisation four times a day creatinine clearance rose and the urographic and renographic appearances returned to normal. These results suggest that, with adequate catheterisation and urinary chemoprophylaxis, infection is not a particular problem in children with bladder dysfunction who undergo renal transplantation.