Long term results of non-refluxing ureteral reimplantation in the pediatric population

Pediatr Surg Int. 2023 Apr 10;39(1):173. doi: 10.1007/s00383-023-05466-2.

Abstract

Purpose: To evaluate the long-term results of UR and to determine the difference between patients with VUR and OMU in terms of re-obstruction rate, complications associated with pregnancy, and de novo reflux.

Methods: Two-site retrospective study with 69 patients (36 females and 33 males) with a mean age of 5 ± 3.4 years. Fifty-nine (85.5%) underwent UR due to VUR and 10 (14.5%) due to OMU. Mean length of surgery and hospitalization was 90 ± 29.2 min and 9 ± 2.4 days, respectively.

Results: Eight (13.5%) patients with VUR suffered from febrile UTI with a mean of 2.1 ± 1.3 events. In the OMU group, 1 (10%) patient suffered from febrile UTI. None of the patients showed recurrence, obstruction or de novo VUR. Two patients (20%) with OMU suffered from CKD. In the VUR group, 3 (5.1%) patients suffered from CKD. Three women suffered from UTIs during pregnancy. Mean follow-up was 17.5 ± 4.6 years.

Conclusions: Successful UR is associated with a decreased rate of febrile UTI in patients with VUR. Patients with OMU maintained and improved renal function in the long term. None demonstrated technical failures in the long term. Patients who presented with bilateral VUR are more prone to developing major complications.

Keywords: Obstructive mega ureter; Reflux; Ureteroneocystostomy.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Renal Insufficiency, Chronic* / complications
  • Replantation / adverse effects
  • Retrospective Studies
  • Ureter* / surgery
  • Urinary Tract Infections* / epidemiology
  • Urinary Tract Infections* / etiology
  • Vesico-Ureteral Reflux* / surgery