The outcome of pre-renal transplant bladder cycling in patients with defunctionalized bladder.

OBJECTIVES

To evaluate the effectiveness of programmed bladder cycling (PBC) prior to transplantation in patients with defunctionalized bladders (DB).

METHODS

This prospective cohort study included RT candidates with DB. Eligible patients underwent pre-transplant PBC, and urodynamic parameters were assessed before and after the intervention. The primary outcome was the improvement in bladder capacity. Secondary outcomes included voiding parameters, and perioperative urological complications.

RESULTS

23 patients underwent PBC for a maximum of 6 months duration. Of these, 20 (86%) patients achieved the targeted bladder capacity of ≥ 250 ml. Median bladder capacity significantly increased from 147.5 mL (IQR 128.8-155) pre-PBC to 265 mL (IQR 253.8-286.3) post-PBC (p < 0.001). Median bladder compliance improved from 12 mL/cmH₂O (IQR 9-14) to 25 mL/cmH₂O (IQR 20.8-30) (p < 0.001). Post-RT, bladder capacity further increased to 314 mL (IQR 310-325) at 3 months and 376 mL (IQR 360-393.5) at 6 months (p < 0.001). Only one patient (5%) developed febrile UTI requiring readmission.

CONCLUSION

PBC is a simple and effective outpatient intervention that significantly improves bladder capacity and compliance in patients with DB and probably decreases complications that may occur during and after renal transplantation.