Urodynamic Evaluation of Lower Urinary Tract Function Both Pre- and Postrenal Transplant and its Relevance to Bladder Management

Introduction: Renal transplant, being considered the treatment of choice for end-stage renal disease, needs a thorough evaluation of the lower urinary tract to avoid any detrimental effect on the allograft. Prolonged dialysis leads to oligoanuria in recipients, which ultimately leads to poor compliance and small capacity bladder. A urodynamic study (UDS) is required to exclude any lower urinary tract dysfunction and helps in early intervention if needed. A pre- and postrenal transplant UDS was performed, and the results were evaluated to assess its importance in pretransplant urological evaluation. Materials and Methods: A prospective observational study was performed from February 2021 to September 2022, where 44 renal transplant recipients with abnormal uroflowmetry were evaluated with UDS both pre- and postrenal transplant. The data were put in Microsoft Excel and statistically analysed by SPSS version 22. Results: Oligoanuric patients had more urodynamic abnormalities in pretransplant stage, namely poor flow, poor compliance, and small capacity bladder. Almost all parameters were significantly improved after renal transplant, except Pdet max and Pdet@Q max . Two patients needed pretransplant surgical intervention in the form of transurethral incision of the prostate. Conclusion: In the absence of a telltale sign of lower urinary tract abnormality, UDS may be avoided in pretransplant evaluation.