Pretransplant defunctionalized bladder-overrated condition?

Neurourol Urodyn. 2018 Jun;37(5):1559-1566. doi: 10.1002/nau.23495. Epub 2018 Jan 22.

Abstract

Aims: The objective of this study was to evaluate the expression of bladder receptors in patients with defunctionalized bladder (DB) and to assess voiding behavior after refunctionalization.

Methods: A total of 68 pretransplant patients were divided in two groups: DB (diuresis <300 mL/24 h; n = 33) and NDB (non-DB; diuresis ≥300 mL/24 h; n = 35). A sample of mucosa and detrusor at the site of the future ureteral implantation was collected. The following receptors were assessed by real-time polymerase chain reaction (qRT-PCR): M2 , M3 , α1D , β3 , P2X2 , P2X3 , TRPV1, TRPV4, TRPA1, and TRPM8. At 3, 6, and 12 months after transplant patients answered IPSS and ICIQ-OAB questionnaires and filled a 3-day 24 h frequency/volume chart (FVC) at 6 and 12 months.

Results: The expression of all receptors in the mucosa and in the detrusor was similar in both groups, except from α1D , which was overexpressed in the detrusor of DB relatively to NDB group. ICIQ-OAB symptom score was similar between the groups at 3, 6, and 12 months. There was a reduction of this score in both groups with time. The same pattern was found for IPSS score. Bother scores were similar between groups. No difference was observed for all FVC parameters between DB and NDB patients.

Conclusion: Gene expression of bladder receptors involved in micturition control was similar in patients with or without DB. Bladder behavior had a similar pattern independently of pretransplant residual diuresis. These findings question the relevance of the term DB in pretransplant patients.

Keywords: bladder receptors; defunctionalized bladder; kidney transplant; urinary frequency.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Gene Expression
  • Humans
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / adverse effects*
  • Kidney Transplantation / methods
  • Lower Urinary Tract Symptoms / etiology
  • Male
  • Middle Aged
  • Mucous Membrane / drug effects
  • Postoperative Period
  • Surveys and Questionnaires
  • Transplant Recipients*
  • Urinary Bladder / innervation
  • Urinary Bladder Diseases / physiopathology*
  • Urination*
  • Urodynamics