Value of the Voiding Cystourethrography prior to Renal Transplantation

Ha, Hyug Soo; Park, Choal Hee; Kim, Chun Il; Cho, Won Hyun; Park, Sung Bae; Kim, Hyun Chul

Abstract

PURPOSE: In many centers, voiding cystourethrography(VCUG) is routinely performed to identify some abnormalities which may compromise the success of transplantation and assess the abnormality of lower urinary tract. To evaluate the value of VCUG as routine pretransplatation workup, we retrospectively reviewed this investigation for renal transplant candidates. MATERIALS AND METHODS: 251 patients underwent transplantation at our center over a 7-year period from August 1990 to July 1996. 229 patients were fully evaluable excluding 22 patients due to incomplete records. All of them were taken VCUG. We tried to find an abnormal VCUG including vesicoureteral reflux, postvoid residual urine(PVR>50ml) and decreased bladder capacity(<100ml). RESULTS: An urological abnormality is identified by VCUG in 29 of 229 patients(12.7%). These abnormalities include 20 patients with VUR alone, 5 patients with increased PVR due to urethral stricture(1), benign prostatic hyperplasia(1), and unknown(3), 1 patient with decreased bladder capacity, 2 patients with unilateral VUR combined PVR, and 1 patient with bilateral VUR combined decreased bladder capacity. 4 of 29 patients had a known urological abnormality as the etiology of end stage renal disease. 41 of 229 patients evaluated had a previous urological history such as frequency, nocturia, urgency, incontinence and dysuria, recurrent UTI and pyelonephritis. But all 29 patients with abnormal VCUGs had a previous those history. 4 of 29 patients were managed due to increased PVR after transplantation as followings: clean intermittent catheterization(3), medication of alpha-blocker for BPH(1). Others were not required further managements. Hence, abnormal findings on VCUG did not lead to a surgical procedure for the abnormality before and/or after transplantation. CONCLUSIONS: These results show that VCUG may be not essential for the routine evaluation for renal transplantation. Therefore, it will necessary in selected individuals with a previous urological history.