The relationship between lower urinary tract dysfunctions and urinary leakage from ureterocystoneoanastomosis in male patients after kidney transplantation

Abstract

The aim of this study was to investigate the association of lower urinary tract dysfunctions with urinary leakage from ureterocystoneoanastomosis (UCNA) after kidney transplantation. BACKGROUND: The UCNA leakage after kidney transplantation can be associated with various conditions while severe lower urinary tract dysfunctions could be one of them. METHODS: The analysis included all men who underwent kidney transplantation between January 2009 and December 2014. The parameters of storage and voiding functions were evaluated. All patients were monitored during their post-transplantation period for the incidence of urinary leakage from UCNA. Urodynamic parameters were compared between men with and without a documented leakage. RESULTS: The study cohort included 127 male patients, while UCNA leakage was observed in 11 (8.7 %) patients. Signifi cant differences between both groups of patients were found for storage parameters (patients with leakage had smaller volume at fi rst and a normal desire to void, smaller maximal cystometric capacity, and lower detrusor compliance) and voiding parameters (patients with leakage had a lower maximal fl ow rate, higher detrusor pressure at maximal fl ow rate and higher bladder outlet obstruction index). CONCLUSION: This study shows an association between lower urinary tract dysfunction and UCNA leakage in men without previous urological history (Tab. 2, Fig. 2, Ref. 24).

The bladder contractility and bladder outlet obstruction indices in adult men: Results of a global Delphi consensus study

“…While men with BOOI > 48.5 had lower improvement in their maximum flow rate, improvement in international prostate symptom score was similar between the groups 25 . A unique study examined the value of BOOI in predicting postrenal transplant urine leak (11 of 127 men) and noted higher odds in men with BOOI > 50 (OR 6.6; sensitivity 80, specificity 70, AUC 0.80, 95% CI 0.65–0.95; p = 0.0018) 26 . Finally, one study classified the Abrams–Griffiths number, the forerunner to BOOI as <15, 15–40, and >40 and noted that men with obstruction were more likely to show an improvement in their maximum flow rate following TURP 27 …”

“…25 A unique study examined the value of BOOI in predicting postrenal transplant urine leak (11 of 127 men) and noted higher odds in men with BOOI > 50 (OR 6.6; sensitivity 80, specificity 70, AUC 0.80, 95% CI 0.65-0.95; p = 0.0018). 26 Finally, one study classified the Abrams-Griffiths number, the forerunner As continuous variable 20…”