MP32-14 CYSTOSCOPY AND BLADDER WASHOUT FOR RECURRENT URINARY TRACT INFECTIONS IN RENAL TRANSPLANT RECIPIENTS

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation & Vascular Surgery II1 Apr 2016MP32-14 CYSTOSCOPY AND BLADDER WASHOUT FOR RECURRENT URINARY TRACT INFECTIONS IN RENAL TRANSPLANT RECIPIENTS Andre Thomas, Benjamin Sherer, and Oyedolamu Olaitan Andre ThomasAndre Thomas More articles by this author , Benjamin ShererBenjamin Sherer More articles by this author , and Oyedolamu OlaitanOyedolamu Olaitan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1309AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urinary tract infection (UTI) is the most common infection in renal transplant recipients (RTRs) and a major cause of morbidity; it is associated with the development of impaired allograft function, allograft loss and increased mortality. The aim of this study is to assess the effect of cystoscopy with bladder washout on the incidence of UTI in RTRs with recurrent complicated urinary tract infections. METHODS We offered cystoscopy with bladder washout to RTRs with recurrent UTIs (confirmed by positive urine culture) who had previously failed at least 2 courses of culture specific antibiotics. Bladder washout was performed via rigid cystourethroscopy under Monitored Anesthesia Care. The bladder was filled to capacity and emptied multiple times with a total of six liters of 0.9% sodium chloride irrigation fluid. We then evaluated for the number of UTIs in the six months pre and post bladder washout. RESULTS Thirty eight (29 female, 9 male) RTRs underwent cystoscopy with bladder washout performed by a single proceduralist between December 2013 and January of 2015. Mean age was 47.8 years. Mean time of bladder washout after renal transplantation was 3.65 years (range 9 months to 14 years). 17 patients (45%) were diabetic. All were on standard immunosuppression and PCP prophylaxis (with trimethoprim/sulfamethoxazole or diaminodiphenyl sulfone). None had a chronic ureteral stent in place. Post-procedurally, patients were followed with monthly urinalysis and culture. The number of UTI's in the 6 months prior to bladder washout (109) significantly decreased by 45% to 60 UTI's in the six months after bladder washout (p<0.02 via Wilcoxon signed rank test) CONCLUSIONS Cystoscopy with bladder washout appears to be effective method to decrease the frequency of UTI's in RTRs. Larger, controlled trials are necessary to confirm these findings. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e433 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Andre Thomas More articles by this author Benjamin Sherer More articles by this author Oyedolamu Olaitan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...