Alyssa,
Yes, you need a catheter in your bladder after the transplant. There are 2 reasons.
1. Some medications (esp pain medications) cause urinary retention and makes it difficult to get the urine out.
2. You will be critically ill post surgery requiring close monitoring of your fluid input and fluid output. The critical care team needs to see how your kidneys are functioning (both by lab tests and by urine output) as well as how well perfused your kidneys are (blood flow to the kidneys). During the transplant, you are on bypass (meaning you are put on a heart and lung machine to perfuse your body). This machine is not the best for delivering the best blood flow to the kidneys. Plus, most anti-rejection medications can be harmful to the kidneys. Therefore, the foley provides us with an indication of how blood flow to the kidneys are doing. If there is minimal urine, this could indicate that some degree of kidney impairment (usually correctable within a few days) or could indicate that you may need some additional fluid (using other lab results, clinical exam, and monitoring devices).
It's an unavoidable part of the transplant. I would assume they would place put the foley catheter in you once you are sedated and we, as a team, try to take out the foley as soon as the patient is out of the immediate critical care period. It's a great way to really assess how your fluid status is... Without the foley, it is difficult during that immediate post-op period to keep a close eye on volume status.
Sorry. That's how we do it for our transplant population. I gather it doesn't differ for other centers. We try not to keep it in long if the patient does well -- it is a source of infection risk and once the patient is awake, out of the immediate critical care phase, and able to tolerate less "urine retention" pain meds, we remove it.
Jenn
30 yo cf
