title: Transurethral resection of the prostate in kidney transplant recipients: urological and renal functional outcomes at long-term follow-up.
abstract: OBJECTIVE
  To assess prospectively the safety and efficacy of transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms attributable to benign prostatic hyperplasia (BPH) in patients who have undergone renal transplantation (RT). To assess the impact of TURP on renal graft function.
  
  
  METHODS
  Urological and renal functional outcomes of TURP performed in RT recipients for treatment of lower urinary tract obstruction attributable to BPH were prospectively assessed in a series of 32 consecutive patients with follow-up of ≥48 months. Maximum urinary flow rate (Qmax ) at uroflowmetry, International Prostate Symptom Score (IPSS), post-void residual urine volume (PVR), haemoglobin and serum creatinine (sCr) levels were recorded before TURP and 1, 6, 24 and 48 months after the procedure. The trends in these variables after TURP were evaluated. Early and delayed complications were assessed and graded according to the Clavien classification system.
  
  
  RESULTS
  TURP was performed at a mean of 6 months after RT. No intraoperative complications occurred. Seven postoperative complications were observed (21.9%): two Clavien grade II and five Clavien grade IIIa. Qmax , IPSS and PVR improved significantly after surgery and the improvement was maintained until 48 months. No patient required a repeat TURP during follow-up. SCr levels significantly decreased 1 and 6 months after TURP and did not significantly increase at long-term follow-up.
  
  
  CONCLUSIONS
  TURP for lower urinary tract obstruction attributable to BPH in RT recipients is safe and effective since it improves urinary flow, bladder emptying and related urinary symptoms. TURP allows an early significant improvement of graft function that is maintained at a follow-up of 48 months.
authors.affiliation: Division of Urology, University of Eastern Piedmont, Novara, Italy. alessandro.volpe@med.unipmn.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Volpe
authors.forename: Michele
authors.initials: M
authors.lastname: Billia
authors.forename: Marco
authors.initials: M
authors.lastname: Quaglia
authors.forename: Matteo
authors.initials: M
authors.lastname: Vidali
authors.forename: Giansilvo
authors.initials: G
authors.lastname: Marchioro
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ceratti
authors.forename: Filippo
authors.initials: F
authors.lastname: Sogni
authors.forename: Elisa
authors.initials: E
authors.lastname: De Lorenzis
authors.forename: Paolo
authors.initials: P
authors.lastname: De Angelis
authors.forename: Andrea
authors.initials: A
authors.lastname: Airoldi
authors.forename: Piero
authors.initials: P
authors.lastname: Stratta
authors.forename: Carlo
authors.initials: C
authors.lastname: Terrone
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000502:physiology; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000150:complications / Q000601:surgery*; D013997:Time Factors; D020728:Transurethral Resection of Prostate / Q000009:adverse effects; D016896:Treatment Outcome
keywords: benign prostatic hyperplasia; bladder outlet obstruction; lower urinary tract symptoms; renal functional outcomes; renal transplantation; transurethral resection