Lower urinary tract symptoms occur commonly during pregnancy with two thirds of women reporting urinary frequency and nocturia. Stress urinary incontinence is reported by 50% of pregnant women and women who experience stress urinary incontinence during pregnancy are more likely to have persistent stress urinary incontinence post-partum. Pelvic floor muscle training is advised for women from 20 weeks of pregnancy who have a first degree relative with pelvic floor dysfunction. For women who fall pregnant following a continence procedure, delivery by Caesarean section is usually recommended. Urinary retention during pregnancy can be acute or chronic and catheterisation is the mainstay of treatment. Care needs to be taken with bladder management in women who have had spinal anaesthesia or following instrumental delivery or perineal trauma. Pregnancy in women following previous urinary tract reconstruction, renal transplantation or with congenital urological anomalies requires multidisciplinary involvement.

This chapter provides a complex review of pediatric renal transplantation. The author discusses the multitude of considerations relevant to patients with chronic kidney disease (e.g. cardiovascular, endocrinologic, hematologic, bone and mineralization homeostasis). The perioperative evaluation is presented in detail in addition to the renal transplant specific anesthetic considerations.