Gynecologic follow up of 129 women on dialysis and after kidney transplantation: a retrospective cohort study

Abstract Objective To describe the gynecologic issues and follow-up in our referral center of women on dialysis and after kidney transplantation. Study design This retrospective cohort study included 129 dialysed women among whom 102 had had transplants. Data on menstrual pattern, pregnancies, contraception, and cervical cytology were retrieved from patients’ files. Results The follow-up started at age 41.6 ± 14.2 years and lasted for 9.5 ± 10.2 years. Of the women, 78.7% had regular menses before dialysis, decreasing to 30.6% on dialysis ( p p p p p  = 0.01), intrauterine growth retardation (28.5%, p p  = 0.008) were significantly higher after transplantation than before dialysis. Prescriptions for the combined contraceptive pill and intrauterine device decreased whereas chlormadinone acetate was widely used: it treated metrorrhagia and relieved mastodynia in 80% and 12% of the cases. Smear tests showed more inflammation (33% vs 0.8%, p vs 3.1%, p  = 0.005) and intraepithelial neoplasias (12.6% vs 2.3%, p  = 0.003) among patients after renal graft than before dialysis. Conclusion Women on dialysis and after kidney transplantation suffered more from irregular menses and metrorrhagia which was improved by chlormadinone acetate. We noted high rates of obstetrical complications and abnormal smear tests. Consequently, this population must have close follow-up to identify and treat gynecologic issues.