Benign Prostatic Hypertropy After Renal Transplantation.

Abstract

Background: It is estimated that more than half of males over 50 have benign prostatic hypertrophy (BPH). As most patients with ESRD are anuric, BPH is under diagnosed in this population. BPH, if diagnosed late, may increase complications following kidney transplantation (KTX). Methods: A single center retrospective cohort review of consecutive male patients over 50 years of age transplanted from Jan. 1, 2010 until Sept. 30, 2013 was performed to assess outcomes between patients with and without BPH and between patients diagnosed with BPH pre-KTX and on medical therapy versus delayed BPH diagnosis post-KTX. Urinary tract complications assessed were: (1) urinary retention (UR) during the KTX admission, (2) discharge with Foley catheter, (3) UR related re-admission, and (4) urinary tract infection (UTI). Results: Of 147 patients, BPH was diagnosed in 34.2%, 15.1% prior to KTX and 19.1% after KTX. Mean follow-up was 673.9± 394.8 days and was not different between those with and without BPH (p=0.37). Compared to those without BPH, BPH was significantly associated with discharge with Foley catheter, re-admission for UR, and UTI after KTX.Table: No Caption available.Post-KTX/delayed BPH diagnosis was also significantly associated with the 4 urinary tract complications assessed.Table: No Caption available.There were no differences in graft function or graft/patient loss between the groups. Conclusions: Following KTX, urinary tract complications are common in patients with BPH. Being started on medical therapy for BPH prior to KTX significantly diminishes the incidence of these complications. This data points to the need for earlier diagnosis of BPH in this subset of transplant patients.