Postoperative voiding dysfunction in older male renal transplant recipients

Transplant Proc. 2009 Jun;41(5):1615-8. doi: 10.1016/j.transproceed.2009.01.110.

Abstract

Objective: To evaluate the incidence of voiding dysfunction in older male renal transplant recipients.

Patients and methods: Data for 103 patients aged 60 years or older (mean age, 65.7 years; group 1) who underwent transplantation at our center between January 1999 and August 2007 were compared with data for a group of 139 younger patients (mean age, 50.1 years; group 2) treated within the same time frame.

Results: Postoperatively, 28 group 1 recipients (27%) and 26 group 2 recipients (19%) experienced voiding dysfunction after removal of the transurethral catheter (P = .12). The most common cause was bladder outlet obstruction due to benign prostatic hyperplasia in 26 patients in group 1 (25%) and 17 patients in group 2 (12%) (P = .009). Bladder neck contracture, urethral stricture, and detrusor underactivity were diagnosed in the other patients. Transurethral resection of the prostate gland was performed in 21 group 1 patients (20%) and 14 group 2 patients (10%) (P = .02) at a mean of 31.1 and 29.5 days, respectively (P = .23) after transplantation. Surgical procedures were performed without complication, and symptoms did not recur postoperatively.

Conclusions: Our data reveal a high incidence of voiding dysfunction in older male renal transplant recipients. High residual urine and urinary retention after renal transplantation may induce recurrent urinary tract infections, cause relevant complications, and seriously affect graft function. Recognizing the substantial effects of postoperative voiding dysfunction will enable optimum management of older kidney transplant recipients.

MeSH terms

  • Aged
  • Aging / physiology*
  • Humans
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Period
  • Prostatectomy
  • Prostatic Hyperplasia / epidemiology
  • Retrospective Studies
  • Urethral Obstruction / epidemiology
  • Urethral Obstruction / etiology*
  • Urethral Obstruction / surgery
  • Urinary Bladder Neck Obstruction / etiology
  • Urinary Bladder Neck Obstruction / surgery
  • Urinary Catheterization
  • Urinary Retention / epidemiology
  • Urinary Retention / etiology*
  • Urodynamics / physiology*