title: Gender has no influence on VUR rates after renal transplantation.
abstract: The influence of recipient gender on urological complications including vesicoureteral reflux (VUR) after renal transplantation has not yet been established. In this study, post-transplantation voiding cystourethrography and ultrasonography were used to evaluate the upper and lower urinary tract in 598 consecutive renal transplant recipients. Our cohort included 209 females and 389 males, respectively. Gender-specific urological complications and potential confounders were analyzed in relation to long-term allograft outcomes. Postoperative urinary retention occurred more frequently in men (P = 0.004). Urinary tract infections (UTIs) were diagnosed more frequently in women after transplantation (P = 0.05). In a multivariate analysis, gender was not a risk factor for VUR [HR, 1.35 (CI, 0.90-1.96); P = 0.14]. VUR rates were influenced by the surgeon's experience level at the time of transplantation [HR, 0.59 (CI, 0.40-0.87); P = 0.008]. No gender-specific differences were seen for ureteral stenosis, leakage, hydronephrosis, death-censored graft or patient survival, and long-term allograft function. Donor/recipient gender mismatch had no impact on postoperative complication rates. In conclusion, male transplant recipients are at risk for developing postoperative urinary retention, whereas female patients more likely develop UTIs. Surgeon's experience level is a risk factor for developing VUR.
authors.affiliation: Division of Obstetrics and feto-maternal Medicine, Department of Gynecology and Obstetrics, Medical University Vienna, General Hospital, Vienna, Austria.
authors.forename: Alex
authors.initials: A
authors.lastname: Farr
authors.forename: Georg
authors.initials: G
authors.lastname: Györi
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Mühlbacher
authors.forename: Peter
authors.initials: P
authors.lastname: Husslein
authors.forename: Georg A
authors.initials: GA
authors.lastname: Böhmig
authors.forename: Markus
authors.initials: M
authors.lastname: Margreiter
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012727:Sex Characteristics; D016055:Urinary Retention / Q000209:etiology; D014552:Urinary Tract Infections / Q000209:etiology; D014718:Vesico-Ureteral Reflux / Q000209:etiology*
keywords: gender; hydronephrosis; renal transplantation; urinary retention; urinary tract infection; vesicoureteral reflux