Van der Weide MJA et al. (2006) Lower urinary tract symptoms after renal transplantation in children. J Urol 175: 297–302

Children receiving renal transplants as a result of pre-existing urological disease are prone to develop lower urinary tract symptoms (LUTS) postoperatively. As bladder dysfunction can damage the new kidney, these patients must be monitored carefully. To determine whether children undergoing kidney transplantation because of nephrological disease should also be rigorously observed for such problems, researchers in The Netherlands studied LUTS in both groups.

The study included 30 of 59 children who received a renal transplant at a medical center in Nijmegen, The Netherlands, between January and May 2003. Of these 30 patients (16 male, mean age at data collection 14 years), 21 had underlying nephrological disease and 9 had underlying urological disease.

Frequency volume data were available for 23 children. Increased postoperative bladder capacity—which can lead to myogenic failure and incontinence—was seen in 12/16 children with nephrological disease and 6/7 urological disease patients. Mean bladder capacities in these children, corrected for growth retardation, were 175% and 207% of normal, respectively. LUTS occurred very frequently, with only one patient experiencing none; presence of residual urine, urinary tract infection and hesitancy were particularly common events. Despite having larger bladder capacities than their younger counterparts, patients who were older at transplant and older at data collection experienced less incontinence.

Because of the high incidence of LUTS and increased bladder capacity in both groups of patients, the authors recommend that all children receiving renal transplants should be monitored for bladder dysfunction. Larger studies are needed to define which patient characteristics are useful indicators of bladder dysfunction following renal transplantation.