Post Renal transplant advised for urethral dilatation

65 years female, actually my mother-in-law,who is a post renal transplant patient Chief Complaints She has been suffering from UTI several episodes in last few months Her doctor nephrologist has advised for a urologist opinion on getting a urethral dilatation done On telephonic consultation, urologist advised for a uroflowmetry and refused for a urethral dilatation seeing the report Management Kindly give your valuable opinion on uroflometry as my brother in law and myself are concerned, she is far away from me too, whether urethral dilatation is needed or not I am not good at reading uroflometry report too, if someone can teach me too😊😊

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Dear dr Ajeet Pal Singh Uroflomatery do not show any obstruction as p/sec exertion approximately 20ml Recurrent UTI is a common complication in renal transplants as pt is on immunosuppressants catches infection secondaly she has one kidney only so total excretion is lesser At the most you can go for cystoscopy And sr creatinine

Thanx dr Kute Ankush
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Uroflometry shows normal maximum for rate but below par average flow rate Decrease contractility of bladder muscle is one of the crucial cause of recurrent urinary tract infection, decreased average flow rate points to the same Adv For prevention of recurrent urinary tract infection 1) Tablet Bethanechol one tablet three times a day (avoid in case of asthma) 2) Tablet cranpac D (cranberry juice extract) one tablet three times a day 3) Strict control of blood sugar with insulin This will help in preventing recurrent urinary tract infection After starting Bethanechol , you can repeat uroflometry to look for improvement in shape for rate

My experience with uroflowmetry was not good They were not able to pass small procedural catheter Then I was on Foley's for 2 to 3 month with urotone25 qds Then after2 month realised flow will be ok One time I got uti Monthly changing of catherer Chance of uti increase Do usg prevoid post void urine Urine culture and sensitivity Then take opinion of nephro& uro

Generally the experience in females of this age group is much less than in males. However, the bulk of the urine is over in 20sec. So extrapolating the average flow rate is more like 7cc/sec. In males of this age the minimum rate for intervention for surgery and or medication is around 10/ sec. Also the machine this is done on is a basic machine . To conclude about the contractility of bladder is not possible.A cystometry and a Uroflowetry as a part of channel urodynamic study on a 4 channel machine like a status or a laborie unit would be more beneficial Considering that she is a post transplant she may also be a diabetic so a surgical procedure should be attempted with due caution. If she currently has an infection, I would certainly repeat a Uroflowetry after a course of antibiotics.Amd take the opportunity to so a Cystometry and a Uroflowetry in the same sitting. At the very least a repeat Uroflowetry on a more elaborate computer based system is advised.

Valuable opinion
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Average flowrate I read as 4 but it is 8 .The advice still stands

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