Pancreas transplantation and dysuria.

Bladder drainage of the pancreatic graft remains the most common technique in pancreatic transplantation. Graft and patient survival is superior to duct injection and bowel drainage techniques. However, several urological complications develop as a result of bladder drainage. We report 6 cases of the dysuria syndrome after combined kidney/pancreas transplantation. Retrograde urethrography or cystoscopy showed extravasation from the bulbous urethra in all cases, which was most likely caused by activated proteolytic exocrine enzymes from the transplanted pancreas. Minor urethral trauma due to Foley catheterization or cystoscopy may predispose patients to this syndrome. Short-term urethral catheterization or suprapubic catheter drainage led to resolution in all cases. A high index of suspicion coupled with early intervention is recommended for patients with the dysuria syndrome.