Document Detail


Durability of antireflux effect of ureteral reimplantation for primary vesicoureteral reflux: findings on long-term cystography.
MedLine Citation:
PMID:  22245304     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the long-term durability of successful ureteral reimplantation (UR) for vesicoureteral reflux (VUR) through a review of late cystography (LC) findings.
MATERIALS AND METHODS: We performed a retrospective chart review of all children with primary VUR who underwent successful open UR (grade 0 VUR into the reimplanted ureter[s] on initial cystogram) at our institution from January 1990 to December 2002. We identified successful UR patients who underwent LC ≥ 1 year after UR and reviewed the results for the presence of recurrent VUR into the reimplanted ureter(s).
RESULTS: Seven-hundred ninety-four patients underwent successful open UR for primary VUR, of whom 60 (7.6%) had a subsequent LC. Preoperative VUR grade was ≤ II in 20 (34.5%) and ≥ III in 38 (65.5%). Median age at UR was 3.5 years (IQR 1.3-6.2 years); 51 (85%) were female. UR was intravesical in 45 (75%) and bilateral in 19 (32%). LC was performed at a median of 38.7 months after UR (IQR 19.6-66.1 months). Indication for LC was febrile urinary tract infection (UTI) in 16 (27%), nonfebrile UTIs in 15 (25%), follow-up of contralateral VUR in 16 (27%), and other clinical indications in 13 (21%). The recurrence rate was 0%; of the 79 reimplanted ureters, 100% (95% CI 95.4-100) had no VUR (grade 0).
CONCLUSION: Among children who underwent successful open UR for primary VUR, there was no VUR recurrence on extended follow-up. This suggests that the late durability of open antireflux surgery is excellent.
Authors:
Katherine C Hubert; Paul J Kokorowski; Lin Huang; Michaella M Prasad; Ilina Rosoklija; Alan B Retik; Caleb P Nelson
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Publication Detail:
Type:  Journal Article; Research Support, American Recovery and Reinvestment Act; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.     Date:  2012-01-13
Journal Detail:
Title:  Urology     Volume:  79     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-05     Completed Date:  2012-05-18     Revised Date:  2013-10-17    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  675-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, Children's Hospital Boston, Boston, MA 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Female
Humans
Infant
Male
Recurrence
Replantation
Retrospective Studies
Treatment Outcome
Ureter / radiography,  surgery*
Urinary Tract Infections / etiology
Urologic Surgical Procedures / methods*
Vesico-Ureteral Reflux / complications,  radiography,  surgery*
Grant Support
ID/Acronym/Agency:
K23 DK088943/DK/NIDDK NIH HHS; K23-DK088943/DK/NIDDK NIH HHS; T32-DK60442/DK/NIDDK NIH HHS; T32-HS19485/HS/AHRQ HHS
Comments/Corrections
Comment In:
J Urol. 2012 Nov;188(5):1941   [PMID:  23059249 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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