<title>ABSTRACT</title><p>Treatment of neurogenic bladder (BN) aims to upper urinary tract protection. When the conservative clinical measures are insufficient, surgical treatment is indicated. Though admittedly important, the quality of life (QoL) has been little studied in these patients, there are even contradictory results. The aim of this study was to evaluate QoL before and after bladder augmentation in patients with BN refractory to medical treatment. We analyzed, prospectively, the data of 67 patients who underwent surgical treatment for BN by questionnaire SF-36® and Qualiveen® QoL before and after six months of operation. Comparisons using paired t-tests and Wilcoxon and the assumption of normality was assessed using the Shapiro-Wilk test were made. According to the analysis of the SF-36® questionnaire, the patients had higher QoL indices in the postoperative period in the areas functional capacity, general state of health, vitality, social aspects, emotional aspects and mental health (n = 67; p <0.05). The questionnaire also revealed Qualiveen® best result in quality of life index in the postoperative period, and show lower specific negative impact by urinary problems (n = 36; p <0.05). The results show that, despite not being the main objective, the bladder augmentation results in significant improvement in QoL, probably related to the perception of better health and the resolution of urinary incontinence. Thus, the bladder augmentation associated with other urologic reconstruction techniques allows the upper urinary tract protection, and contribute to a better quality of life of patients with BN.</p>

OBJETIVOS: O crescimento de um rim em resposta à perda do outro rim recebe o nome de hipertrofia renal compensatória. Entretanto, os mecanismos que regulam esse processo ainda não foram esclarecidos. Neste estudo, avaliaram-se os efeitos da icterícia obstrutiva na morfologia e na função do rim remanescente após nefrectomia unilateral. MÉTODOS: Foram estudados 40 ratos Wistar (250g-300 g), distribuídos nos seguintes grupos: Grupo 1 - operação simulada; Grupo 2 - nefrectomia direita; Grupo 3 - ligadura do ducto biliar; Grupo 4 - ligadura do ducto biliar e nefrectomia direita. Os animais foram mortos após 20 dias, quando foi colhido sangue para exames laboratoriais e feita a retirada dos rins e do fígado. Os rins foram pesados para avaliação do crescimento compensatório. Rins e fígado foram estudados histologicamente por microscopia óptica. RESULTADOS: Não houve diferença no aumento do peso renal relativo entre os animais dos Grupos 2 e 4 (p = 0,4). Os animais submetidos à ligadura do ducto biliar isoladamente (Grupo 3) apresentaram maior peso renal relativo quando comparados com os animais submetidos à operação simulada (Grupo 1) (p = 0,011). As alterações histológicas encontradas foram dilatação capilar da camada medular nos rins hipertrofiados e modificações típicas de colestase nos fígados dos animais ictéricos. Cirrose foi encontrada apenas nos animais submetidos à nefrectomia. CONCLUSÃO: O peso e a função do rim remanescente após nefrectomia unilateral não são afetados pela icterícia obstrutiva.

OBJECTIVE: The removal of one kidney results in a compensatory growth of the remnant kidney. However, the mechanism that underlies this hypertrophic response is not understood. In this study we assessed the influence of obstructive jaundice on renal morphology and function after unilateral nephrectomy. METHODS: Forty Wistar rats (250-300 g) were randomly divided into four groups: Group 1 - sham operation, Group 2 - right nephrectomy, Group 3 - common bile duct ligation, Group 4 - common bile duct ligation and right nephrectomy. After 20 days, blood was collected for biochemical studies and the animals were killed. Their kidneys and livers were removed and weighed. Histological evaluation of both organs was carried out. RESULTS: No difference in the kidney/body weight ratio was observed for animals undergoing right nephrectomy (Groups 2 and 4) (p = 0.4). Animals submitted to bile duct ligation only (Group 3) presented a higher kidney/body weight ratio than animals submitted to sham operation (Group 1) (p = 0.011). Vasodilatation was identified in the medulla of the hypertrophied kidneys and histological alterations were found in the livers of the jaundiced animals. Cirrhosis occurred only in nephrectomized rats. CONCLUSION: Cholestasis does not affect the weight, function or the compensatory renal growth of the remnant kidney after unilateral nephrectomy.