Presentation Authors: Felipe Hirasaki*, Rogerio Sayao Filho, Renato Falci, Ioannis Antonopoulos, Kleiton Yamaçake, Hideki Kanashiro, Gustavo Ebaid, Gustavo Messi, Alexandre Bull, Rafael Locali, Affonso Piovesan, William Nahas, Sao Paulo, Brazil
Introduction: Urinary tract infection is the most common type of bacterial infection in kidney transplant procedures, with adverse effects on graft and patient survival.Successful bladder drainage is imperative for successful transplant outcomes. Perfect timing for urinary catheter withdrawal is unknown and longer catheter use may increase the incidence of urinary tract infections (UTI). Therefore, we hypothesized that early catheter withdrawal may reduce the risk of UTI.The main objective is to evaluate the outcomes of early withdrawal of the urinary catheter following kidney transplant regarding UTI and urinary tract postoperative complications (UTPC).
Methods: A retrospective search on our database was performed, searching for all cases of renal transplant that had the information about urinary catheter withdrawal (UCW) between January 2017 and July 2018.We divided into 2 groups: group A - UCW on the third postoperative day and group B - UCW on or after the fifth postoperative day. Outcomes regarding UTI and UTPC were compared between the two groups. We considered only UTI and UTC cases that occurred within three months after the urinary catheter removal. Data were analysed using the Chi-square test and Fisher exact test.
Results: 320 renal transplants were performed during the selected period, of which, 250 had the information about UCW.Thirty-four patients, who had undergone renal transplant surgery, had their urinary catheter removed on the third postoperative day. This group showed two cases of UTI within three months after catheter removal. No other UTPC was found.Additionally, 216 patients had their urinary catheter removed on the fifth postoperative or afterwards . Fifty-six cases of UTI were found and only three UTPC cases occurred: two uretheral fistulas and one uretheral stenosis. There was a statistically significant difference between the two groups regarding UTI: Group A (6.1%) x Group B (26%) â€“ p < 0,005. No difference was found regarding UTPC (p=0,650).
Conclusions: Early urinary catheter withdrawal in patients who had undergone renal transplant surgery showed a significant decrease in UTI incidents within three months and showed no further UTPC. Therefore, it should be considered as standard practice following renal transplant.