[Urodynamics in kidney transplantation]

The importance of establishing a protocol for the urological evaluation of patients awaiting renal transplantation is due to the fact that 30% of these adult patients and up to 70% of these children develop renal failure due to a urological condition. The present study analyzes the importance of urodynamic evaluation in these patients.

650 patients awaiting renal transplantation were evaluated by patient history, physical examination, US, Cystouretyhrography, and flowmetry. Thereafter 201 patients with the following conditions were selected for urodynamic assessment: vesicoureteral reflux, changes in bladder morphology (diverticulum, trabeculation), inadequate infundibulization of the bladder neck, diabetes, neurogenic bladder, obstructive pathology and bladders with a small volume capacity. The urodynamic study consisted of instantaneous voiding, cystomanometry and urethral pressure profile.

Of these 201 patients, 45 had vesical hyperreflexia, 45 bladder disuse, 95 had a normal bladder, 12 had a hypoactive bladder and 2 had detrusor instability.

The urodynamic study, apart from flowmetry, is basically indicated in patients awaiting renal transplantation who have a neurogenic bladder and/or suspected as having lower urinary tract obstruction.