BERKELEY, CA (UroToday.com) - We observed that the removal of urinary catheters within 24 hours of kidney transplantation did not increase the incidence of urine leaks as might be expected from such expeditious catheter removal. Instead, we demonstrated improved patient comfort and mobility and a decreased the risk of catheter-associated urinary tract infection. Our recent study analyzed 120 consecutive live donor kidney transplant recipients, 81 (68%) of whom had their urinary catheters removed within 24 hours. Of these patients, 6 (7.4%), developed urine leaks. Of the 39 patients who had their catheters in place for greater than 24 hours, 3 (7.7%) developed urine leaks, demonstrating a similar risk of urine leak between the two groups.
At our institution, we utilize a full-thickness ureter to bladder anastomosis, as opposed to the intravesicular Leadbetter-Politano technique or the extravesicular Lich-Gregoir technique. While not eliminating the risk entirely, we believe this practice allows for a more effective ureteroneocystostomy closure.
As a result of this study, we speculate that urine leaks are not associated with early urinary catheter removal but are rather a result of other factors including, but not limited to, microvesicular damage to the ureteral blood supply, induction therapy, and surgical technique. It is our intent to continue early removal of urinary catheters following kidney transplantation in order to decrease associated urinary tract infections – and therefore patient morbidity and hospital length-of-stay – while increasing patient ambulation, comfort, and recovery.
Adam Kressel, MD, Eric Siskind, MD, and Ernesto Molmenti, MD, PhD, MBA as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Department of Transplantation, North Shore Long Island Jewish Health System, Hofstra University School of Medicine, Manhasset, NY USA