Old habits die hard; does early urinary catheter removal affect kidney size, bacteriuria and UTI after renal transplantation?

Abstract

Introduction: Renal transplantation is the treatment of choice in chronic renal failure patients. Objectives: The purpose of this study was to evaluate the impact of urinary catheter removal time on transplanted kidney size and incidence of asymptomatic bacteriuria and urinary tract infections (UTIs). Patients and Methods: This retrospective cohort study evaluated the clinical outcomes of 109 consecutive live donor renal transplant recipients from December 2011 to July 2014. Routine ultrasound examinations were performed on donor’s kidney prior to operation and one month later. Kidney volume was calculated. UTI and bacteriuria were evaluated one month later. Patients were divided into two groups based on time of Foley catheter removal (before and after fifth day posttransplantation). Results: In this study 74 males (67.9%) and 35 females (32.1%) were evaluated. Sixty-six patients (57.92%) were in group 1. None of the patients with positive urine culture had UTI but bacteriuria occurred in all of them (21.1%). Bacteriuria time after transplantation and catheter removal was significantly later in group 1 and it was not different in female group but they were later in male group. The mean renal volume increase was positively correlated to renal transplant recipient and donor’s age and donor’s body mass index (BMI) (P<0.05). Conclusion: This study showed that the time of catheter removal after kidney transplantation does not affect incidence of UTI but increases the probability of bacteria in men whose catheter was removed within 5 days after transplantation. We also found that the renal volume change is not associated with catheter removal time and bacteriuria.

Timing of Urinary Catheter Removal Following Kidney Transplantation: A Retrospective Study

“…Foley d1 recipients (n=186) versus Foley >d1 recipients (n = 327) were significantly less likely to have pretransplant antibodies against human leukocyte antigens and have a ureteral stent placed at transplantation ( Table 2 ). 2 , 3 , 4 , 6 Urine leak occurred in 1.1% of Foley d1 and 1.2% of Foley >d1 recipients ( P > 0.99). The d1 group was significantly more likely to experience Foley reinsertion or intermittent catheterization after removal (11% vs 5%, P = 0.02) and less likely to have length of stay >4 days (47% vs 57%, P = 0.03).…”

“… 1 Bladder catheterization has remained constant. 2 , 3 , 4 , 5 , 6 Foley catheter use facilitates bladder identification by retrograde saline infusion into the bladder before anastomosis. After transplantation, the Foley catheter prevents tension on the new anastomosis by continuous drainage of urine and is typically maintained in place for 4-10 days to prevent urinary complications.…”

“…After transplantation, the Foley catheter prevents tension on the new anastomosis by continuous drainage of urine and is typically maintained in place for 4-10 days to prevent urinary complications. 2 , 5 However, the optimal Foley duration to minimize urinary complications is unknown.…”

Working towards an ERAS Protocol for Pancreatic Transplantation: A Narrative Review

“…Similarly, early catheter removal may also be beneficial to pancreas transplant recipients. They are routinely inserted in renal transplant to allow for close monitoring of urine production, but multiple studies have shown that patients can safely tolerate catheter removal within 48 h of surgery [ 212 , 213 , 214 , 215 ]. Meta-analyses within other surgical specialities have demonstrated decreased incidence of urinary tract infections and retention with early removal [ 216 , 217 ].…”

Sterile versus clean urinary catheterisation is not associated with post‐transplantation infection

“…1 Urinary tract infection (UTI) is the most common nosocomial infection in the post-transplantation period, ranging from 35% to 79% prevalence. 2,3 Sequelae range from no impairment to allograft function, through to allograft loss and death. 2 Risk factors for UTIs can be divided into recipient, donor, and procedure related factors.…”