Damage to the spinal cord, nerves, and complications from congenital or acquired neurological conditions used to mean a lifetime of progressive deterioration that would slowly weaken kidney function. Up until the last two decades, the field of urology had few options to treat neurogenic bladder. Current regimens focus on more than symptom management. They aim to prevent further kidney damage and improve quality of life.
The Situation:
The 45-year-old male patient lived with end-stage renal disease. Years before, he had been the victim of a gunshot wound to the back, which resulted in neurogenic bladder and urinary dysfunction. He was weak, dialysis-dependent, and running out of time.
A year into treatment, he made the decision to improve his health so that he would remain a viable candidate for kidney transplant. The patient lost 120 pounds, followed his renal diet closely, and stayed as active as possible.
He turned to Evgeniy Kreydin, MD, a urological surgeon at Keck Medicine of USC and assistant professor of clinical urology at Keck School of Medicine of USC. A formal workup revealed persistent elevated bladder pressure resulting in overactive bladder, spasticity, and urinary incontinence. The patient’s symptoms were non-responsive to Botox injections, leaving surgery as his only alternative.
The Treatment:
In August 2019, the patient underwent a seven-hour bladder augmentation surgery, or cystoplasty, using his own bowel tissue to expand bladder capacity and decrease pressure. Dr. Kreydin also formed a Mitrofanoff channel for self-catheterization to bypass his damaged urethra. This life-saving procedure helped to bridge the patient to a successful kidney transplant at Keck Hospital of USC in February 2021.
Post-Treatment:
Today, the patient is thriving and says he feels very blessed. He has returned to full physical activity, spending each day exercising, running his company, and enjoying ordinary activities.
Leading Urological Care at Keck Medicine
From kidney stones to cancer, Keck Medicine of USC offers advanced care for every urologic condition. Comprised of over 60 specialists, including board-certified urologists, surgeons, radiologists, researchers, residents, and postgraduate fellows, our team stands proud as a leader in the field of urology.
Experts in our USC Center for Genito-Urinary Reconstruction and Prosthetics aim to correct problems and improve quality of life. As one of the first institutions in the world to offer surgical alternatives to treat complex urinary incontinence, our program has grown to include cutting-edge robotic, laparoscopic, endourologic, prosthetic, and reconstructive options that customize care to the individual patient. Patients benefit from access to groundbreaking clinical trials, and participation in our Enhanced Recovery After Surgery (ERAS) program supports engagement and education that aims to improve post-surgical outcomes by optimizing pain control, shortening hospital stays, and decreasing complications.