ABSTRACT
Objectives
To study the necessity of pre-transplant programmed bladder cycling (PBC) in patients
with defunctionalized bladder (DB).
Methods
This RCT included renal transplant (RT) candidates with DB. Eligible patients were
assigned to two groups, group I underwent PBC before RT and group II underwent direct
RT into the DB. The primary outcome was to assess the efficacy of PBC in improving
post- RT bladder capacity. Secondly, to compare its impact on early urological complications
and 3-month voiding function and 1-year graft function and survival. Graft function
was evaluated using serum creatinine and eGFR using MDRD equation.
Results
Groups I included 23 patients and group II included 20 patients. The mean ±SD of bladder
capacity was 88.7±11.7ml and 90.6 ±9.8ml in both groups, respectively (P= 0.5). In
group I, PBC increased bladder capacity to 194.7 ±21.2 ml (P<0.001). Targeted bladder
capacity was achieved in 19 (82.6 %) patients and two patients developed UTI. At 3-months,
bladder capacity, compliance and bladder contractility index improved significantly
in both groups with a significant reduction in maximum detrusor pressure with no significant
difference between both groups (P= 0.3,0.4, 0.2 and 0.8, respectively). Urinary leakage
occurred in one (4.3%) and three patients (15%) in group 1 and 2, respectively (P=0.2).
At 1-year, no statistically significant differences in the median (IQR) serum creatinine
(P= 0.05) and eGFR (P= 0.07) between both groups were noted.
Conclusions
Pre-transplant PBC for DB-patients provided no clinical advantage concerning postoperative
urological complication, urodynamic criteria and graft function and survival.
KEY WORDS
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Article info
Publication history
Accepted:
January 8,
2023
Received:
October 26,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Authors details:
Funding: No fund
Acknowledgment: This manuscript was proofread by dr. Mirna Yasser
Disclosure: Authors have no conflict of interest to disclose
Authors contribution
Yasser Osman: Idea and draft writing
Mohamed H Zahran: Data collection, statistical analysis and writing
Ahmed M Harraz: Statistical analysis and review of the manuscript
Mohamed Mashally: Data collection
Ahmed I. Kamal: Data collection
Bedeir Ali-El-Dein: Supervising and review
Identification
Copyright
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