Titre du document / Document title

Common sheath reimplantation yields excellent results in the treatment of vesicoureteral reflux in duplicated collecting systems

Auteur(s) / Author(s)

ELLSWORTH P. I. ; LIM D. J. ; WALKER R. D. ; STEVENS P. S. ; BARRAZA M. A. ; MESROBIAN H.-G. J. ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Nemours Children's Clinic, Jacksonville, ETATS-UNIS

Résumé / Abstract

Purpose : We evaluated our 10-year experience with the surgical treatment of vesicoureteral reflux in uncomplicated duplicated collecting systems. Materials and Methods : Between 1984 and 1994, 54 refluxing renal units (8 bilateral) in 37 female and 9 male patients required surgery. Patient age ranged from 7 months to 17 years (average 4.9 at surgery). Postoperative followup (average 14.2 months) included voiding cystourethrography and renal sonography or excretory urography. Results : Common sheath ureteral reimplantation via an intravesical approach was performed in 48 of the 54 refluxing renal units. Of the remaining 6 renal units detrussorrhaphy was performed in 4, and ureteroureterostomy combined with ureteral reimplantation and partial lower pole nephrectomy were done in 1 each. Two treated renal units had persistent postoperative vesicoureteral reflux, which resolved after subureteral polytetrafluoroethylene (Teflon) injection. No renal unit had postoperative hydronephrosis. Contralateral reflux was identified in 1 patient who underwent unilateral reimplantation. Our overall success rate was 96% for the surgical correction of vesicoureteral reflux in uncomplicated duplicated collecting systems. Common sheath reimplantation had a 98% success rate. Conclusions : Although a duplicated collecting system increases the risk for surgical treatment, the presence of a duplication anomaly does not adversely affect surgical outcome. Modifications of procedures commonly performed in the surgical treatment of single system reflux to accommodate common sheath reimplantation have excellent surgical results with minimal morbidity.

Revue / Journal Title

The Journal of urology   ISSN 0022-5347   CODEN JOURAA 

Source / Source

Congrès
Annual meeting of American Urological Association, Las Vegas, Nevada , ETATS-UNIS (23/04/1995)
1996, vol. 155, n^o4, pp. 1407-1409 (20 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS  (1917) (Revue)

Mots-clés anglais / English Keywords

Duplication ; Ureter ; Complication ; Vesicoureteral reflux ; Treatment ; Replantation ; Community ; Case ; Technique ; Result ; Human ; Urinary system disease ; Urinary tract disease ; Congenital disease ; Malformation ; Bladder disease ; Surgery ;

Mots-clés français / French Keywords

Duplication ; Uretère ; Complication ; Reflux vésicourétéral ; Traitement ; Réimplantation ; Communauté ; Fourreau ; Technique ; Résultat ; Homme ; Appareil urinaire pathologie ; Voie urinaire pathologie ; Maladie congénitale ; Malformation ; Vessie pathologie ; Chirurgie ;

Mots-clés espagnols / Spanish Keywords

Duplicación ; Uréter ; Complicación ; Reflujo vesicoureteral ; Tratamiento ; Reimplantación ; Comunidad ; Vaina ; Técnica ; Resultado ; Hombre ; Aparato urinario patología ; Vía urinaria patología ; Enfermedad congénita ; Malformación ; Vejiga patología ; Cirugía ;

Localisation / Location

INIST-CNRS, Cote INIST : 2081, 35400005330734.0700