Kidney transplant complications from undiagnosed benign prostatic hypertrophy

Clin Transplant. 2015 Jun;29(6):539-42. doi: 10.1111/ctr.12548. Epub 2015 May 9.

Abstract

Background: It is estimated that approximately 50% of males over 50 have benign prostatic hypertrophy (BPH). BPH is underappreciated in anuric patients with end stage renal disease, and failure of diagnosis in this population can lead to complications after kidney transplantation.

Methods: A single-center retrospective review of male patients over 50 yr of age transplanted from January 1, 2010, until September 30, 2013, was performed. Outcomes assessed were as follows: graft survival, urinary retention, discharge with Foley catheter, and urinary tract infection (UTI).

Results: Of 147 patients, 17.0% were diagnosed with BPH before transplant, 19.0% received a BPH diagnosis after transplant, and 64% did not have BPH. Compared to those without BPH, a post-transplant BPH diagnosis was associated with urinary retention during the transplant admission (0% vs. 46.4%, p < 0.01), discharge with Foley catheter (0% vs. 21.4%, p < 0.01), readmission related to urinary retention (0% vs. 46.4%, p < 0.01), and UTI (18.0% vs. 64.3%, p < 0.01). Patients with prior diagnosis of BPH and on therapy had similar outcomes to those without BPH.

Conclusions: Following kidney transplant, urinary tract complications are more common in patients with BPH; however, being on medical therapy prior to transplantation diminishes the incidence of these complications significantly.

Keywords: complications; kidney transplantation; prostatic hypertrophy.

Publication types

  • Evaluation Study

MeSH terms

  • 5-alpha Reductase Inhibitors / therapeutic use
  • Adrenergic alpha-Antagonists / therapeutic use
  • Aged
  • Aged, 80 and over
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Postoperative Complications / etiology*
  • Preoperative Care
  • Prostatic Hyperplasia / complications*
  • Prostatic Hyperplasia / diagnosis
  • Prostatic Hyperplasia / drug therapy
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Urologic Diseases / etiology*

Substances

  • 5-alpha Reductase Inhibitors
  • Adrenergic alpha-Antagonists