Gender has no influence on VUR rates after renal transplantation

Abstract

SummaryThe influence of recipient gender on urological complications including vesicoureteral reflux (VUR) after renal transplantation has not yet been established. In this study, post-transplantation voiding cystourethrography and ultrasonography were used to evaluate the upper and lower urinary tract in 598 consecutive renal transplant recipients. Our cohort included 209 females and 389 males, respectively. Gender-specific urological complications and potential confounders were analyzed in relation to long-term allograft outcomes. Postoperative urinary retention occurred more frequently in men (P = 0.004). Urinary tract infections (UTIs) were diagnosed more frequently in women after transplantation (P = 0.05). In a multivariate analysis, gender was not a risk factor for VUR [HR, 1.35 (CI, 0.90-1.96); P = 0.14]. VUR rates were influenced by the surgeon's experience level at the time of transplantation [HR, 0.59 (CI, 0.40-0.87); P = 0.008]. No gender-specific differences were seen for ureteral stenosis, leakage, hydronephrosis, death-censored graft or patient survival, and long-term allograft function. Donor/recipient gender mismatch had no impact on postoperative complication rates. In conclusion, male transplant recipients are at risk for developing postoperative urinary retention, whereas female patients more likely develop UTIs. Surgeon's experience level is a risk factor for developing VUR.

Antimicrobial resistance and recurrent bacterial urinary tract infections in hospitalized patients following kidney transplantation: A single‐center experience

“…The highest incidence has been reported within 6 months following KT, likely related to surgical manipulation and concurrent use of immunosuppressive treatment 12 . Some patients experience recurrent UTIs during this period with a prevalence between 4% and 72% 13,14 . In addition to immunosuppression, KT patients have mechanical risk factors for UTIs.…”

Allograft Vesicoureteral Reflux after Kidney Transplantation

“…In their study, no differences were observed between experienced and inexperienced surgeons [28]. On the contrary, a multivariate analysis by Farr et al has shown that surgical experience is the most significant predictor of post-transplant VUR, even after multiple adjustments for potential confounders and sex-specific urological complications [15].…”

“…Most literature suggests that females may be more prone to allograft VUR and UTIs [11][12][13][14]. However, in a study specifically designed to assess the effect of sex on VUR, Farr et al observed that, on multivariate analysis, no sex-specific differences could be detected [15].…”

Reflujo vesicoureteral sintomático posterior al injerto renal en adultos: tratamiento endourológico y reacción con agentes bloqueantes

“…5,[10][11][12] Entre los factores de riesgo para reflujo vesicoureteral se encuentran: capacidad vesical disminuida previa al trasplante y falta de experiencia del cirujano. 1,13 Los pacientes con infección de vías urinarias después del trasplante renal tienen mayor riesgo de pérdida del injerto y mortalidad. 14 Dupont y su grupo encontraron que los pacientes con infección de vías urinarias y reflujo vesicoureteral posterior a trasplante renal tuvieron mayor incidencia cicatrices renales que quienes no tuvieron reflujo.…”