Acta clinica Croatica, Vol. 45 No. 3, 2006.
Professional paper
Choice of Operative Methods for Primary Vesicoureteral Reflux
Borislav Spajić
Jasna Ðelmiš
Marija Spajić
Goran Štimac
Josip Katušić
Ognjen Kraus
Abstract
Results of ureteral reimplantation in infants with primary vesicoureteral reflux (VUR) were retrospectively reviewed and evaluated. From January 1991 till December 2000, a total of 156 patients with primary VUR underwent ureteral reimplantation at University Department of Urology, Sestre milosrdnice University Hospital, Zagreb, Croatia. The indications for surgery were high-grade reflux, breakthrough urinary tract infections, and non-compliance with medical treatment. Ureteral reimplantation was performed according to Cohen.s method (134/156) and Gil-Vernet (22/156) transvesical method. Out of 156 patients treated for primary VUR, 57 patients presented with left sided VUR and 40 with right sided VUR, whereas 52 patients required treatment for bilateral VUR, giving a total of 219 VUR repairs. Five patients had ureteral duplication accompanied by one sided VUR, whereas two patients had ureteral duplication accompanied by bilateral VUR. Out of the 156 surgically treated patients 2 (1.28%) presented with recurrent VUR, 3 (1.93%) with contralateral VUR, 5 (3.2%) patients were treated for urinary tract infection postoperatively, and none of our patients presented with stenosis. The overall complication-free percentage of surgically treated VUR in our study was 93.6%, while 96.8% were successfully treated for VUR. The present results show that transvesical ureteral repairs in infants are safe and very effective for the prevention of urinary tract infections. After surgical treatment in infancy, the individual renal growth of children with primary VUR is stable.
Keywords
Vesico-ureteral reflux - therapy; Vesico-ureteral reflux - surgery; Ureter surgery - methods; Child
Hrčak ID:
14061
URI
Publication date:
1.9.2006.
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