Docs reconstruct artificial bladder of 17-yr-old before kidney

A 17-year-old boy combating three life-threatening problems is now on the path to recovery thanks to doctors at a private hospital here who reconstructed an artificial bladder before taking him through a kidney transplant.
Faced with three life-threatening problems, Ravi Tomar had almost given up hope. He was born with a spinal cord defect which caused trouble in his bladder and eventually led to kidney failure.
In a complex treatment protocol, doctors at BLK hospital here first recreated and enlarged Ravi's bladder and trained him to empty the bladder himself before doing the kidney transplant.
"Ravi's case was complex. He was born with a spinal cord defect called Spina Bifida (Meningomyelocele). This condition weakened his bladder functions because the nerves supplying blood to the bladder were damaged by the defect of the spine.

"Eventually, as a result of the bladder dysfunction, his kidney got progressively damaged and that led to kidney failure," said Dr Aditya Pradhan, Senior Consultant of Urology and Renal Transplantation at the hospital.
Ravi's parents had visited several hospitals where doctors had refused renal transplantation because of the complexities involved, he said.

"At the time the patient came to the hospital, he was in end-stage kidney disease. His urinary bladder was very small and he could retain only 20-ml urine," Pradhan added.
To treat Ravi, the doctors planned a special protocol and designed a three-stage intervention schedule.
"The first stage involved reconstruction of the bladder from the bowel loops. In the second stage, the patient was trained to empty the bladder. Then, in the third stage, the kidney transplant was done successfully," said Dr Yajvender Pratap Singh Rana, Consultant, Urology & Renal Transplantation, at the hospital.

The entire procedure from bladder reconstruction to kidney transplantation took more than four months. Pradhan said that Ravi's kidney is now functioning well and he has recovered fast.