Intermittent Clean Catheterization: An Alternative to diversion in Continent Transplant Recipients with Lower Urinary Tract Dysfunction

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Abstract
Renal transplant recipients who were candidates for urinary diversion underwent successful transplantation using a planned program of intermittent clean catheterization. The urinary tract dysfunction was caused by lower motor neuron neurogenic bladder, prune belly syndrome and myelodysplasia. The patients remain dry between catheterizations and maintain serum creatinine levels of 1.1, 0.8 and 0.5 mg percent, respectively, with a followup of 6 to 25 mo. There was only 1 urinary tract infection during 42 patient-mo. at risk while on self-catheterization. Pre-transplant urologic evaluation and patient education are mandatory. The ideal candidate for intermittent clear catheterization is a patient with low pressure bladder that fails to empty and who is continent between catheterizations. Intermittent clean catheterization is a safe and effective alternative to diversion in continent transplant recipients with lower urinary tract dysfunction.