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- W2015758833 abstract "You have accessJournal of UrologyTransplantation & Vascular Surgery I1 Apr 2014PD30-07 DOES TURP REDUCE URINARY TRACT INFECTION AND URINARY RETENTION IN PATIENTS WITH BPH RECEIVING RENAL TRANSPLANT? Karl Coutinho, Kris Stensland, Rajiv Jayadevan, and Courtney Phillips Karl CoutinhoKarl Coutinho More articles by this author , Kris StenslandKris Stensland More articles by this author , Rajiv JayadevanRajiv Jayadevan More articles by this author , and Courtney PhillipsCourtney Phillips More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2130AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The rate of renal transplant (RTx) in patients aged 50 and older has steadily increased, with the number of geriatric RTx (≥ 65) tripling between 1998 and 2011. The incidence of benign prostatic hyperplasia (BPH) increases with age, with rates as high as 50-80% at 65 years old. BPH is a predisposing factor for urinary retention (UR) as well as urinary tract infections (UTI); recurrent UTI has been correlated with both renal scarring and increased rates of RTx failure. The purpose of this study is to determine if early treatment of BPH with transuretheral resection of the prostate (TURP) may reduce the rates of UTI and UR in RTx recipients. METHODS An institution-wide clinical database was queried to identify patients who had undergone both RTx and TURP between January 1, 2006 and May 1, 2012. Clinical and surgical data was collected. RESULTS Out of 1,318 RTx performed between January 1, 2006 and May 1, 2012, 23 men received both RTx and TURP. Of these, 10 patients were excluded due to incomplete data. The mean age at RTx was 67.5 years. 12 patients received cadaveric RTx and 1 patient had a living donor. The median time between RTx and TURP was 6.8 months. Median post-RTx follow-up was 25.1 months and median post-TURP follow-up was 11.7 months. Of the 13 evaluable patients, indications for TURP were recurrent UTI’s in 7, UR in 3, and both in 3 patients. Mean pre-op UD parameters were as follows: bladder capacity 260cc; Qmax 7.4 cc/s; maximum Pdet 102.5 cmH2O and PVR 68.75 cc. Patients had an average of 4.7 post-RTx ED visits or admissions, with an average of 3.1 visits between transplant and TURP and 1.6 visits after TURP. The most common causes for ED visit or admission were fever and UTI. Of the 7 patients with recurrent UTI’s, 4 showed marked improvement in UTI frequency (≤1 UTI on follow-up), while 3 showed no improvement. All 3 patients with UR were able to void post-operatively while 2 of 3 patients with both UR and UTI’s showed improvement. Five patients had post-op UD’s: 2 for persistent infections, 1 for new-onset urinary symptoms and 2 for routine follow-up. Mean bladder capacity was 299 cc; mean max Pdet was 36.2 cm H20; mean Qmax was 13.8 cc/s and average PVR was 17 cc. CONCLUSIONS UTI and UR are associated with increased rates of graft failure. With an aging population of patients receiving RTx, the number of patients at increased risk of UTI and UR secondary to BPH also increases. This small study shows that post-RTx TURP may decrease rates of recurrent UTI and UR, which may in turn reduce the risk of chronic graft rejection. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e776 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Karl Coutinho More articles by this author Kris Stensland More articles by this author Rajiv Jayadevan More articles by this author Courtney Phillips More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ..." @default.
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- W2015758833 date "2014-04-01" @default.
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- W2015758833 title "PD30-07 DOES TURP REDUCE URINARY TRACT INFECTION AND URINARY RETENTION IN PATIENTS WITH BPH RECEIVING RENAL TRANSPLANT?" @default.
- W2015758833 doi "https://doi.org/10.1016/j.juro.2014.02.2130" @default.
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