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Enterocystoplasty in preparation for renal transplantation in children with severely dysfunctional bladders is widely accepted by pediatric urologists and transplant surgeons alike. The risk for septic and other complications in this immunosuppressed population remains elevated however, since problems inherent to the use of bowel or stomach in the urinary tract become magnified in these patients. In addition, simultaneous enterocystoplasty and transplantation carry a significant risk, and we must therefore subject these children to two major operations within a short time span. We herein describe our experience with combining simultaneously ureterocystoplasty and renal transplantation in a child. We believe this procedure has major relevance, in particular in the group of patients with posterior urethral valves and chronic renal failure.