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• W2022145727 abstract "No AccessJournal of UrologyReflux/Infection1 Sep 2000ARE POSTOPERATIVE STUDIES JUSTIFIED AFTER EXTRAVESICAL URETERAL REIMPLANTATION? DIEGO BARRIERAS, STEVEN LAPOINTE, PRAMOD P. REDDY, PIERRE WILLIOT, GORDON A. McLORIE, DARIUS B|fGLI, ANTOINE E. KHOURY, and PAUL A. MERGUERIAN DIEGO BARRIERASDIEGO BARRIERAS More articles by this author , STEVEN LAPOINTESTEVEN LAPOINTE More articles by this author , PRAMOD P. REDDYPRAMOD P. REDDY More articles by this author , PIERRE WILLIOTPIERRE WILLIOT More articles by this author , GORDON A. McLORIEGORDON A. McLORIE More articles by this author , DARIUS B|fGLIDARIUS B|fGLI More articles by this author , ANTOINE E. KHOURYANTOINE E. KHOURY More articles by this author , and PAUL A. MERGUERIANPAUL A. MERGUERIAN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67251-5AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the usefulness of postoperative imaging studies after extravesical ureteroneocystostomy and identified patient subsets in which these studies are necessary. Materials and Methods: Records of 438 patients who had undergone extravesical ureteroneocystostomy from 1991 to 1997 were reviewed retrospectively. Study inclusion criterion was primary reflux with at least 1 year of postoperative followup. Grades I to III reflux were defined as low, and grades IV and V were defined as high. All patients were on prophylactic antibiotics. Evaluation included ultrasound and a voiding cystourethrogram 3 months postoperatively, and if reflux persisted the studies were repeated at 12 months. Results: A total of 438 patients (723 renal units) underwent extravesical ureteral reimplantation. At 3 months the procedure was successful in 93.2% of ureters (91.3% patients), and at 12 months the success rate increased to 97.9% of ureters (95.4% patients). There were 49 renal units in 38 cases that were refluxing at 3 months, 11 of which were contralateral. At 12 months reflux resolved spontaneously in 20 of 38 ipsilateral and 8 of 11 contralateral ureters. Of the remaining 18 ipsilateral units reflux was high grade preoperatively in 12 and persisted postoperatively in 4. There was a statistically significant difference in the success rate at 1 year between high (94%) versus low (99%) grade reflux (p = 0.007). Age and preoperative bladder function did not significantly affect the success rates but males had a lower success rate. Hydronephrosis was noted in 7.2% of ureters at 6 weeks and in only 0.005% at 12 months. Conclusions: Extravesical reimplantation is successful in treating vesicoureteral reflux. Postoperative voiding cystourethrogram should be reserved for high grade reflux. Limiting these studies will help reduce patient discomfort and the cost of treatment. References 1 : Treatment of vesicoureteric reflux. Results of a prospective study. Br J Urol1993; 71: 346. Google Scholar 2 : Resolution of vesicoureteral reflux during medical management in children. Pediatr Nephrol1995; 9: 715. Google Scholar 3 : A nonsurgical approach to the management of primary vesicoureteral reflux. J Urol1987; 138: 941. Link, Google Scholar 4 : Vesicoureteral reflux: a surgeon's perspective. Pediatr Clin North Am1982; 29: 827. Google Scholar 5 : Lich-Gregoir anti-reflux operation: a surgical experience and 5-20 years of follow-up in 149 ureters. Eur Urol1989; 16: 200. Google Scholar 6 : Outcome analysis of bilateral Cohen cross-trigonal ureteroneocystostomy. Urology1995; 46: 393. 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Link, Google Scholar From the Division of Urology, The Hospital for Sick Children, University of Toronto, Toronto, Ontario and Hospital Sainte-Justine, Universite de Montreal, Montreal, Quebec, Canada© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMittal S, Aghababian A, Eftekharzadeh S, Saxena S, Janssen K, Lombardo A, Adamic B, Dinardo L, Weaver J, Fischer K, Andolfi C, Long C, Weiss D, Kirsch A, Srinivasan A, Gundeti M and Shukla A (2022) Robot-Assisted Laparoscopic Ureterocalicostomy in the Setting of Ureteropelvic Junction Obstruction: A Multi-Institutional CohortJournal of Urology, VOL. 208, NO. 1, (180-185), Online publication date: 1-Jul-2022.Lee Y, Im Y, Jung H, Hah Y, Hong C and Han S (2018) Does Hydronephrosis After Extravesical Ureteral Reimplantation Deteriorate Renal Function?Journal of Urology, VOL. 187, NO. 2, (670-675), Online publication date: 1-Feb-2012.Hubert K, Kokorowski P, Huang L, Prasad M, Rosoklija I, Retik A and Nelson C (2012) Clinical Outcomes and Long-Term Resolution in Patients with Persistent Vesicoureteral Reflux After Open Ureteral ReimplantationJournal of Urology, VOL. 188, NO. 4S, (1474-1479), Online publication date: 1-Oct-2012.Zamilpa I, Koyle M, Grady R, Joyner B, Shnorhavorian M and Lendvay T (2011) Can we Rely on the Presence of Dextranomer-Hyaluronic Acid Copolymer Mounds on Ultrasound to Predict Vesicoureteral Reflux Resolution After Injection Therapy?Journal of Urology, VOL. 185, NO. 6S, (2536-2541), Online publication date: 1-Jun-2011.Elder J, Diaz M, Caldamone A, Cendron M, Greenfield S, Hurwitz R, Kirsch A, Koyle M, Pope J and Shapiro E (2018) Endoscopic Therapy for Vesicoureteral Reflux: A Meta-Analysis. 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Reflux Resolution and Urinary Tract InfectionJournal of Urology, VOL. 175, NO. 2, (716-722), Online publication date: 1-Feb-2006.CHARBONNEAU S, TACKETT L, GRAY E, CAESAR R and CALDAMONE A (2018) IS LONG-TERM SONOGRAPHIC FOLLOWUP NECESSARY AFTER UNCOMPLICATED URETERAL REIMPLANTATION IN CHILDREN?Journal of Urology, VOL. 174, NO. 4 Part 1, (1429-1432), Online publication date: 1-Oct-2005.NEPPLE K, AUSTIN J, HAWTREY C and COOPER C (2018) KIDNEYS WITH REFLUX NEPHROPATHY MAINTAIN RELATIVE RENAL FUNCTION AFTER URETERAL REIMPLANTATIONJournal of Urology, VOL. 174, NO. 4 Part 2, (1606-1608), Online publication date: 1-Oct-2005.DeFOOR W, MINEVICH E, REDDY P, POLSKY E, McGREGOR A, WACKSMAN J and SHELDON C (2018) RESULTS OF TAPERED URETERAL REIMPLANTATION FOR PRIMARY MEGAURETER: EXTRAVESICAL VERSUS INTRAVESICAL APPROACHJournal of Urology, VOL. 172, NO. 4 Part 2, (1640-1643), Online publication date: 1-Oct-2004.ABOUTALEB H, BOLDUC S, UPADHYAY J, FARHAT W, BÄGLI D and KHOURY A (2018) Subureteral Polydimethylsiloxane Injection Versus Extravesical Reimplantation For Primary Low Grade Vesicoureteral Reflux in Children: A Comparative StudyJournal of Urology, VOL. 169, NO. 1, (313-316), Online publication date: 1-Jan-2003.ABOUTALEB H, BOLDUC S, BÄGLI D and KHOURY A (2018) Correlation of Vesicoureteral Reflux With Degree of Hydronephrosis and the Impact of Antireflux SurgeryJournal of Urology, VOL. 170, NO. 4 Part 2, (1560-1562), Online publication date: 1-Oct-2003.OSWALD J, RICCABONA M, LUSUARDI L, ULMER H, BARTSCH G and RADMAYR C (2018) Voiding Cystourethrography Using the Suprapubic Versus Transurethral Route in Infants and Children: Results of a Prospective Pain Scale Oriented StudyJournal of Urology, VOL. 168, NO. 6, (2586-2589), Online publication date: 1-Dec-2002. Volume 164Issue 3 Part 2September 2000Page: 1064-1066 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsreplantationurinationvesico-ureteral refluxMetricsAuthor Information DIEGO BARRIERAS More articles by this author STEVEN LAPOINTE More articles by this author PRAMOD P. REDDY More articles by this author PIERRE WILLIOT More articles by this author GORDON A. McLORIE More articles by this author DARIUS B|fGLI More articles by this author ANTOINE E. KHOURY More articles by this author PAUL A. MERGUERIAN More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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