Mp31-09 outcomes of bladder washout for treatment of recurrent urinary tract infections after renal transplantation

You have accessJournal of UrologyCME1 Apr 2023MP31-09 OUTCOMES OF BLADDER WASHOUT FOR TREATMENT OF RECURRENT URINARY TRACT INFECTIONS AFTER RENAL TRANSPLANTATION Ari Spellman, Spencer Mossack, Oyedolamu Olaitin, and Carlos Santos Ari SpellmanAri Spellman More articles by this author , Spencer MossackSpencer Mossack More articles by this author , Oyedolamu OlaitinOyedolamu Olaitin More articles by this author , and Carlos SantosCarlos Santos More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003264.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Current literature suggests that anywhere from 2.9-27% of renal transplant recipients (RTR) will develop recurrent UTI ( ≥2 UTIs over 6 months or ≥3 UTIs over 12 months). Recurrent UTI is of particular importance to RTR given its increased risk for allograft fibrosis and overall patient survival. Management of recurrent UTI involves addressing structural and functional abnormalities of the urinary tract along with antibiotic treatment. Alternative solutions are needed for management of recurrent UTI, especially given the vulnerability of RTR to UTI. We hypothesize that bladder washout (BW) reduces the incidence and recurrence of UTIs in RTR. METHODS: This is a retrospective study evaluating the utility of BW procedures on RTR diagnosed with a recurrent UTI between December 2013 and July 2021 at RUMC. Data collected includes demographics, transplant information, urinalyses, urine cultures (including organism and sensitivities), and antibiotic usage (type, duration, setting and route), in the 6 months preceding and following BW. Data was analyzed using t-tests, chi-square tests, and Fisher exact tests, as appropriate. RESULTS: A total of 106 patients were included in the study with a total of 118 BW performed. 69% of patients were successfully treated with BW, meaning they no longer met criteria for recurrent UTI ( <1 UTI) in the 6-month post-BW period. The bladder washout success rate was significantly higher in patients identifying as white (80.65%) compared to patients who identified as Latino (51.28%). No other demographics had differences in bladder washout success rates. The mean number of UTI was 2.76 (range 2-7) before the BW and 1.16 (range 0-5) after the BW. On average, there were 1.60 fewer UTIs in the post-BW period compared to the pre-BW period (p<0.0001). Treatment success rates by bacterial class based on immediate pre-BW UTI were 67%, 75%, and 71.43% for Enterobacterales, Enterococci, and other bacteria respectively. There is no statistically significant difference in success rates stratified by bacterial class (p=1) or antimicrobial resistance class (p=0.6937).There were no post-operative complications relating to the BW procedure in any patient. CONCLUSIONS: In our study population, BW’s decreased the incidence UTIs in the 6-month post-operative period as nearly 70% of patients did not have UTI recurrence. BW was shown to be an effective adjunctive treatment for recurrent UTIs. These findings provide data to support the use of BW in this patient population. Source of Funding: Rush University Department of Surgery © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e433 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ari Spellman More articles by this author Spencer Mossack More articles by this author Oyedolamu Olaitin More articles by this author Carlos Santos More articles by this author Expand All Advertisement PDF downloadLoading ...