Functional Recovery of Hypocompliant Defunctionalized Bladder Due to Long-Term Dialysis After Kidney Transplantation.

Abstract

Objectives: It has been reported that oliguria due to long-term dialysis decreases bladder capacity, and the small bladder recovers its capacity after kidney transplantation. However, functional recovery of hypocompliant defunctionalized bladder due to long-term dialysis including intravesical pressure and bladder compliance have not yet been well documented. Materials and Methods: Sixty one recipients, who underwent cystometry both before and 1 year after transplantation, were enrolled. Bladder compliance was evaluated by cystometry. A bladder with compliance of less than 10 mL/cmH2O was defined as a hypocompliant bladder. Urinary complications including urinary tract infection (UTI) and vesicoureteral reflux (VUR) were retrospectively evaluated. Results: Dialysis duration was significantly correlated with pretransplant low bladder compliance (R2 = 0.418, p < 0.001).Figure: No Caption available.Pretransplant hypocompliant bladder was observed in 16 (26.2%) of all the 61 patients and in 10 (83.3%) of 12 patients whose dialysis duration was more than 5 years. In the 16 patients with pretransplant hypocompliant bladder, cystometric bladder capacity, maximum intravesical pressure, and bladder compliance were significantly recovered at 1 year after transplantation (p < 0.0001, p = 0.003, p = 0.001, respectively).Figure: No Caption available.Prevalence of urinary complications including VUR or UTI was not increased in patients with the pretransplant hypocompliant bladder. Conclusion: Pretransplant hypocompliant defunctionalized bladder due to long-term dialysis significantly recovered their function at 1 year after transplantation without an increase in the prevalence of urinary complications including VUR or UTI.