Prevalence and Management of Lower Urinary Tract Symptoms Related to Benign Prostatic Obstruction in a Contemporary Series of Renal Transplant Recipients

Ergesi, Bjorn; Winkler, Yvonne; Kistler, Thomas; Grimm, Marc‐Oliver; John, Hubert; Horstmann, Marcus

doi:10.5812/numonthly.35497

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…A retrospective cohort study on 23.622 recipients [14] reported an incidence of 9.7% and 7.3% of BPH and TURP, respectively, 3 years after RT, without stratifying by age. More recently, a retrospective study on 131 recipients, showed a benign prostatic obstruction prevalence of 58% between 60 and 70 years, and 71% above 70 years [15].…”

Section: Discussionmentioning

confidence: 99%

“…For patients with an indwelling bladder catheter, we considered the sCr and eGFR levels before the catheterization. LUTS were categorized into mild (IPSS score 1-7), moderate (IPSS score [8][9][10][11][12][13][14][15][16][17][18][19], and severe (IPSS score [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. We considered the following UD variables: bladder capacity (< 100, 100-300, > 300 mL), Qmax (mL/s), detrusor pressure at Qmax (PdetQmax; cmH2O), PVR (< 1/3 of bladder capacity, > 1/3 of bladder capacity).…”

Section: Covariatesmentioning

confidence: 99%

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Patients with renal transplant and moderate-to-severe LUTS benefit from urodynamic evaluation and early transurethral resection of the prostate

et al. 2021

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Purpose To assess long-term renal function and micturition pattern of males submitted to transurethral resection of the prostate (TURP) for moderate-to-severe lower urinary tract symptoms (LUTS) after renal transplantation (RT). To investigate the role of clinical and urodynamic (UD) parameters for bladder outlet obstruction (BOO) diagnosis in these patients. Methods Retrospective data analysis of ≥ 50 years old patients who underwent RT between 01/2005 and 12/2016. Patients with moderate-to-severe LUTS after RT who underwent a urologic evaluation and a UD study were included. TURP was performed in case of BOO diagnosis. Kidney function and micturition patterns were evaluated before, 3, 12, 24, 36, and 48 months after TURP. Predictors of BOO were assessed at univariable and multivariable logistic regression models. Statistical analysis was performed with STATA16. Results 233 male patients ≥ 50 years underwent RT. 71/233 (30%) patients developed voiding LUTS. 52/71 (73%) patients with moderate-to-severe LUTS underwent UD. TURP was performed in 36/52 (69%) patients, with BOO diagnosis. Median (interquartile range) follow-up was 108 (75–136) months. Maximum flow at flowmetry (Qmax), International Prostate Symptom Score and post-voided residual volume improved significantly after surgery. Serum creatinine decreased and glomerular filtration rate improved significantly at follow-up, especially when TURP was performed ≤ 6 months from RT. At the multivariable model, bladder capacity ≥ 300 mL (OR = 1.74, CI 95% 1.03–3.15, p = 0.043) and detrusor pressure at Qmax (OR = 2.05, CI 95% 1.48–3.02, p = 0.035) were the independent predictors of BOO. Conclusion RT patients with moderate-to-severe LUTS at risk for BOO and graft failure are better identified by UD than clinical parameters. Bladder capacity and voiding pressure are key for the early diagnosis of BOO.

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Section: Discussionmentioning

confidence: 99%

Section: Covariatesmentioning

confidence: 99%

Patients with renal transplant and moderate-to-severe LUTS benefit from urodynamic evaluation and early transurethral resection of the prostate

et al. 2021

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“…Optimal bladder function is another important requirement. [8] After RT, urine flow increases, and preexisting BPH or BOO may cause urinary retention. [9] Urinary retention is the most predominant symptom of BOO.…”

Section: Discussionmentioning

confidence: 99%

The outcomes of transurethral incision/resection of the prostate (TUIP/TURP) performed early after renal transplantation

Sarıer

Duman

Demir

et al. 2018

Turkish Journal of Urology

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Objective: In the early period after renal transplantation, urinary retention stemming from bladder outlet obstruction (BOO) may directly affect graft success. The aim of this study was to evaluate the early and long-term outcomes of transurethral resection of the prostate (TURP) and transurethral incision of prostate (TUIP) procedures performed in the first month following RT due to BOO. Material and methods:Between February 2009 and March 2016, 38 male patients underwent TURP/ TUIP due to BOO within the first 30 days of renal transplantation. The urodynamic and renal function assessment results of all patients were collected during the pre-and postoperative periods. All patients were followed up for a minimum of 12 months for short and long-term complications. The results were evaluated retrospectively. Results:The mean age of the patients who underwent operations was 59.2±12 years. The median duration of dialysis was 41 months (range 0-180). Before the operation the mean serum creatinine (sCr) level was 1.8±0.7 mg/dL, the mean total PSA level was 1.6±1.1 ng/mL. Of the voiding parameters, the mean Qmax and Qave were measured as 8.2±4.5 mL/sec and 4.6±2.5 mL/sec, respectively. The median post-micturition residual urine (PMR) was 105 mL (range 10-400). TURP/TUIP operations were performed at a median of 19 days (range 8-30) after renal transplantations. None of the patients experienced major complications. In the early postoperative period, 5 patients (13.1%) developed urinary tract infection. The mean decrease in sCr in the first month following TURP/TUIP was 1.4±0.4 mg/dL (p<0.001). The mean Qmax (22.4±11.1 mL/sec), and Qave (11.7±5.4 mL/sec) increased significantly (p<0.001), while the median PMR (15 mL, range 0-205) decreased significantly (p<0.001). The mean follow-up period after the procedure was 46.8±23.3 months. During the follow-up period, 3 (7.8%) patients suffered from urethral stricture and 2 (5.2%) patients from bladder neck obstruction. Conclusion:In the surgical treatment of urinary retention arising from BOO in the first month following renal transplantation, TURP/TUIP yield safe and successful results. In addition, regarding the short and long term outcomes, these procedures may be safely performed with low morbidity.

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Benefits and Harms of Benign Prostatic Obstruction Treatments in Renal Transplanted Patients

Zakri¹,

Hevia²,

Bossier³

et al. 2023

European Urology Focus

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Prevalence and Management of Lower Urinary Tract Symptoms Related to Benign Prostatic Obstruction in a Contemporary Series of Renal Transplant Recipients

Cited by 5 publications

References 15 publications

Patients with renal transplant and moderate-to-severe LUTS benefit from urodynamic evaluation and early transurethral resection of the prostate

Patients with renal transplant and moderate-to-severe LUTS benefit from urodynamic evaluation and early transurethral resection of the prostate

The outcomes of transurethral incision/resection of the prostate (TUIP/TURP) performed early after renal transplantation

Benefits and Harms of Benign Prostatic Obstruction Treatments in Renal Transplanted Patients

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