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Nursing Care of the Patient With Neurogenic Bladder After Kidney Transplantation: A Case Report
Authors:Zeliha Ozdemir Koken  Rana Elcin Sezer  Kubra Tosun
Affiliation:1. Surgical Nursing Department, Hacettepe University Faculty of Nursing, Ankara, Turkey;2. Department of Urology, Hacettepe University Adult Hospital, Ankara, Turkey
Abstract:ObjectiveUrologic complications are among the most common complications after kidney transplantation. These complications are urinary retention, hematuria, hemorrhage, urinary leakage, vesicoureteral reflux, pyelonephritis, and nephrolithiasis. Although neurogenic bladder is one of the indications for kidney transplantation, it is not considered in the literature to be an expected complication after transplantation. In this case, we discuss the nursing care of a patient who underwent kidney transplantation from a living donor and developed neurogenic bladder.Case reportA 60-year-old woman underwent kidney transplantation from a living donor, and neurogenic bladder developed in the patient 1 year after kidney transplantation. Clear intermittent catheterization treatment was administered for the kidney transplant recipient with neurogenic bladder. Clear intermittent catheterization treatment was stopped in the patient who had frequent urinary tract infections and, alternatively, sacral neuromodulation treatment was administered to the patient.ConclusionsThe nursing care of a patient with neurogenic bladder after kidney transplantation aims to prevent excessive bladder distension, infection, stone formation, vesicoureteral reflux, renal failure, urinary tract damage, and incontinence, and to ensure regular and complete discharge of the bladder. The most common treatment modalities for these objectives are permanent or intermittent catheterization, sacral neuromodulation, and medical therapy. In the care of the patient with neurogenic bladder after kidney transplantation, nurses should provide appropriate care related to treatment options and bladder training, plan urination schedules of the patient, and monitor for possible complications.
Keywords:Address correspondence to Zeliha Ozdemir Koken, PhD, Hacettepe University Faculty of Nursing, Adnan Saygun Street, D-Block, 1st Floor, 06100-Altindag, Ankara, Turkey. Tel.: +90 312 305 15 80   Fax: +90 312 312 70 85.
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