Objectives: To evaluate the indications for urodynamics studies (UDS) previ
ous to renal transplantation (RT) and the results of bladder cycling (BC),
performed in selected cases.
Methods: Among 475 RT, 33 patients (6.9%) required UDS according our protoc
ol. indications were: (1) low urinary tract symptoms (LUTS); (2) defunction
alized bladder (DB), and (3) complex urologic history (reflux, neurogenic b
ladder, urethral valves, etc.). DB was defined as a total urinary output of
<300 ml/24 h. Patients with DB underwent BC through a suprapubic catheter,
undergoing UDS after BC. The rate and type of urodynamic anomalies were co
mpared among the 3 groups. Cystometric capacity (CysCap) and compliance wer
e evaluated according to the etiology of renal failure, diuresis, and numbe
r of previous bladder surgeries.
Results: Fifteen patients (45%) showed abnormal UDS, Increased pressure at
cystometry was the most frequent finding (46%). The rate of abnormal UDS am
ong the 3 groups was not statistically significant (66.6% in DB, 42.8% in L
UTS, and 35% in those with complex urologic history). Compliance and CysCap
were significantly lower in the patients with DB, showing a significant co
rrelation with diuresis. These parameters did not correlate with the number
of previous bladder surgeries. BC resulted in normal UDS in 3 patients (33
%) and a change in diagnosis in 2 patients (22%).
Conclusion: Our indications gave a good diagnostic yield. Patients with DB
represent a group with different urodynamic findings. BC provides a more pr
ecise diagnosis or normalization of UDS in some cases. Copyright (C) 2000 S
. Karger AG. Basel.