title: Correlations between pretransplant dialysis duration, bladder capacity, and prevalence of vesicoureteral reflux to the graft.
abstract: BACKGROUND
  Urinary bladder capacity is reduced in patients undergoing long-term dialysis, which may increase the risk of vesicoureteral reflux (VUR) to a transplanted kidney. This study investigated the correlations between dialysis duration, pretransplant and posttransplant bladder capacity, and prevalence of VUR to the graft.
  
  
  METHODS
  Voiding cystography was performed in 101 adult renal transplant recipients without neurogenic disorders immediately before and 1 year after transplantation to evaluate bladder capacity and VUR. Nonstented extravesical antireflux ureteroneocystostomy was performed in all patients.
  
  
  RESULTS
  The median dialysis duration and pretransplant bladder capacity were 32 months (range 1-426 months) and 120 mL (range 15-450 mL), and 21 patients (20.8%) underwent dialysis for more than 120 months, and 30 patients (29.7%) had a pretransplant bladder capacity of less than 80 mL. Dialysis duration was correlated with pretransplant bladder capacity (R=0.466, P<0.001). Bladder capacity expanded more than 6-fold from pretransplantation to posttransplantation, and all recipients had a bladder capacity greater than 150 mL at 1 year posttransplantation. Thirty patients had VUR to the graft. Dialysis duration longer than 60 months (P=0.021) and pretransplant bladder capacity of less than 130 mL (P=0.024) were associated with VUR. VUR was associated with lower graft function.
  
  
  CONCLUSIONS
  Although bladder capacity decreased because of long-term dialysis, it exceeded 150 mL at 1 year posttransplantation. A small bladder can be used in renal transplantation, but it may increase the risk of VUR.
authors.affiliation: Department of Urology, Akita University School of Medicine, Akita, Japan.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Inoue
authors.forename: Shigeru
authors.initials: S
authors.lastname: Satoh
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Saito
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Numakura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsuruta
authors.forename: Takashi
authors.initials: T
authors.lastname: Obara
authors.forename: Shintaro
authors.initials: S
authors.lastname: Narita
authors.forename: Yohei
authors.initials: Y
authors.lastname: Horikawa
authors.forename: Norihiko
authors.initials: N
authors.lastname: Tsuchiya
authors.forename: Tomonori
authors.initials: T
authors.lastname: Habuchi
mesh_terms: D000328:Adult; D000368:Aged; D003559:Cystostomy / Q000379:methods; D005260:Female; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011183:Postoperative Complications / Q000453:epidemiology*; D011300:Preoperative Care / Q000706:statistics & numerical data; D015995:Prevalence; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D013997:Time Factors; D001743:Urinary Bladder / Q000033:anatomy & histology / Q000502:physiology*; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology*; D055815:Young Adult