Bladder dysfunction and end stage renal disease.

INTRODUCTION AND OBJECTIVES: Evaluation of lower urinary tract function in patients with end-stage renal disease and lower urinary tract symptoms. Patients were screened before entering a renal transplantation program.

MATERIALS AND METHODS: A diagnostic work-up including urodynamics was performed on 52 patients (14 women, 38 men) suffering from renal failure due to chronic glomerulonephritis (n = 25), diabetic nephropathy (n = 15), chronic pyelonephritis/stone disease (n = 9) and polycystic kidney disease (n = 3).

RESULTS: Abnormalities in lower urinary tract function of different degrees were found in 40 patients (77%). Major problems are bladder hypersensitivity (n = 31%), poor bladder compliance (38%), detrusor instability (25%) and detrusor-sphincter dyssynergia (33%).

CONCLUSIONS: There is a high incidence of bladder dysfunction of different degrees in patients with renal failure. The clinical significance, especially in the long term, needs to be evaluated. However, a urodynamic assessment before renal transplantation is recommended in all patients reporting symptoms of dysfunctional voiding and/or bladder storage problems in order to avoid allograft dysfunction due to chronic bladder dysfunction and related complications. Depending on the degree of bladder dysfunction an urodynamic follow-up after transplantation is necessary. If there are no symptoms and no history of lower urinary tract dysfunction an urodynamic assessment is not necessary.