title: Improvement of urinary dysfunction after kidney transplantation by administration of the antimuscarinic agent--prospective randomized controlled study.
abstract: BACKGROUND
  Bladder dysfunction after kidney transplantation (KTx) impairs the patients' quality of life. We examined the bladder function status perioperatively in patients undergoing KTx and performed a randomized prospective study to determine the efficacy of an antimuscarinic agent, solifenacin, in ameliorating the bladder dysfunction after KTx.
  
  
  METHODS
  The subjects in this study were 33 patients who underwent KTx at our institution. The patients were divided into two groups: group 1 (n=18), composed of patients who were not treated with any antimuscarinic agent, and group 2 (n=15), composed of patients treated with an antimuscarinic agent. We investigated the actual bladder function status of these patients before and after KTx by the following two methods: (1) video water cystometry and (2) questionnaire study using the Overactive Bladder Symptom Score and King's Health Questionnaire.
  
  
  RESULTS
  The cystometry study revealed a significantly greater increase of the maximum cystometric capacity in group 2 than in group 1 (173.0±60.7 mL in group 1 and 260.1±51.0 mL in group 2 [P=0.005]) after KTx. In the questionnaire surveys, the decreases in the scores for all domains were observed 6 weeks after KTx. The scores in group 2 tended to be lower than those in group 1.
  
  
  CONCLUSIONS
  In all of our patients, the bladder dysfunction status improved dramatically after KTx. In addition, our results suggest that administration of the antimuscarinic agent, solifenacin, may contribute to improvement of the quality of life of patients undergoing KTx.
authors.affiliation: Department of Urology, Tokyo Women's Medical University, Tokyo, Japan. tunoyama925@gmail.com
authors.forename: Kuniko
authors.initials: K
authors.lastname: Tsunoyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishida
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Shimizu
authors.forename: Kazuya
authors.initials: K
authors.lastname: Omoto
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
mesh_terms: D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D011812:Quinuclidines / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000009:adverse effects; D000069464:Solifenacin Succinate; D011795:Surveys and Questionnaires; D044005:Tetrahydroisoquinolines / Q000627:therapeutic use*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology; D001745:Urinary Bladder Diseases / Q000188:drug therapy* / Q000209:etiology
chemical_list: D018727:Muscarinic Antagonists; D011812:Quinuclidines; D044005:Tetrahydroisoquinolines; D000069464:Solifenacin Succinate