Impact of de novo vesicoureteral reflux on transurethral surgery outcomes in pediatric patients with ureteroceles
| Autor: | Sangmin Lee, Kun Suk Kim, Donghyun Lee, Hwiwoo Kim, Sang Hoon Song, Sungchan Park, Jongpil Lee, Donghyun Ahn |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Urology Urinary system 030232 urology & nephrology Renal function Punctures lcsh:RC870-923 urologic and male genital diseases Vesicoureteral reflux 03 medical and health sciences 0302 clinical medicine Postoperative Complications Urethra medicine Ureteroscopy Humans Child Hydronephrosis Retrospective Studies Vesico-Ureteral Reflux Pediatric Urology Ureterocele medicine.diagnostic_test business.industry Medical record Infant Endoscopy Perioperative lcsh:Diseases of the genitourinary system. Urology medicine.disease Urinary tract infections female genital diseases and pregnancy complications Treatment Outcome 030220 oncology & carcinogenesis Child Preschool Urologic Surgical Procedures Original Article Female Kidney Diseases business |
| Zdroj: | Investigative and Clinical Urology Investigative and Clinical Urology, Vol 60, Iss 4, Pp 295-302 (2019) |
| ISSN: | 2466-054X 2466-0493 |
| Popis: | Purpose We aimed to determine the impact of de novo vesicoureteral reflux (VUR) on postoperative urinary tract infection (UTI) and renal function in pediatric patients with ureteroceles. Materials and methods We retrospectively reviewed the medical records of 34 patients (36 renal units) with ureteroceles that were treated endoscopically. Perioperative radiologic and clinical data regarding de novo VUR, UTI, and renal function were analyzed. Logistic regression analysis was used to identify factors that predicted unfavorable surgical outcomes, such as primary surgical failure, postoperative UTI, and deterioration of renal function. Results Of the 36 renal units, 22 had a duplex system (61.1%). Preoperative VUR was noted in 9 units (25.0%), including 3 units without renal duplication. Endoscopic surgery successfully decompressed the ureterocele and hydronephrosis in 28 units (77.8%). De novo VUR developed in 18 renal units (50.0%) postoperatively. The absence or presence of de novo VUR was not related to unfavorable surgical outcomes in univariate or multivariate analyses. Even after selection for the 28 renal units without preoperative VUR, the occurrence of de novo VUR had no predictive value for unfavorable surgical outcomes. Moreover, among the 14 renal units without renal duplication, de novo VUR had no predictive value for any of these adverse outcomes. Conclusions After endoscopic ureterocele puncture, de novo VUR is not significantly associated with postoperative UTI or deterioration in renal function in the long term. It may not, therefore, be necessary to reconstruct lower urinary tract routinely to correct de novo VUR after endoscopic puncture of the ureterocele. |
| Databáze: | OpenAIRE |
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