The following is the summary of “A Contemporary Evaluation of Urological Outcomes After Renal Transplantation” published in the January 2023 issue of Urology by Kennedy, et al.

Patients undergoing urologic procedures after receiving a kidney transplant are at increased risk for infection and other urological problems. Their goal was to identify those patients who would benefit from close urological follow-up after renal transplantation by identifying patient criteria linked with unfavorable outcomes. Data from patients at a tertiary academic center who had a kidney transplant between August 1, 2016 and July 30, 2019 were reviewed retrospectively. A patient’s demographic information, medical history, and surgery history were all recorded. Primary outcomes included occurrences of urinary tract infection, urosepsis, urine retention, an unscheduled visit to the urologist, and urological operations within three months of the donation. 

Logistic regression models were developed for each primary outcome, utilizing the variables that were found to be significant through hypothesis testing. Out of 789 patients who underwent a kidney transplant, 217 (27.5%) were diagnosed with a urinary tract infection and 124 (15.7%) were diagnosed with urosepsis after surgery. Patients with a urinary tract infection after surgery were more likely to be female (odds ratio = 2.2, P<.01), to have a history of prostate cancer (odds ratio=3.1, P<.01), and to have recurrent urinary tract infections (odds ratio=2.1, P<.01). Among the patients who underwent a renal transplant, 64 (8.2%) underwent urological procedures and 191 (24.2%) had unscheduled visits to the urologist. 

Patients with benign prostatic hyperplasia (OR 2.8, P=.033) and those who had previous prostate surgery (OR 3.0, P=.072) were more likely to experience urine retention after surgery, which affected 47 (6.0%) patients. Renal transplant recipients are at increased risk for developing urological problems like benign prostatic hyperplasia, prostate cancer, urine retention, and recurrent UTIs if these conditions are present. Urinary tract infections and urosepsis are common complications for female kidney transplant recipients after surgery. Urological treatment and pre-transplant urological examination, including urinalysis, urine cultures, urodynamic investigations, and close follow-up post-transplant, would be beneficial for these patient subsets.

Source: auajournals.org/doi/10.1097/UPJ.0000000000000353