Vesicoureteral reflux treatment: Ureteroneocystostomy

Key Findings & Data:Material and Method: The files of the 46 VUR patients [23 girl, 23 boys, mean age 6,4 years (two months-17 years)] who were treated with ureteral reimplantation were retrospectively evaluated.

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Conclusion & Impact:The overall success rate of ureteral reimplantation was 97,5% in this series.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Vezikoüreteral reflü · Geriyedönük çalışma · Ürolojik cerrahi prosedürler

Abstract

Aim: Medical treatment for vesicoureteral reflux (VUR) has been proposed in patients with low or moderate grade VUR. Surgical treatment is required in patients with failed medical management. We present our experience with ureteral reimplantation for VUR. Material and Method: The files of the 46 VUR patients [23 girl, 23 boys, mean age 6,4 years (two months-17 years)] who were treated with ureteral reimplantation were retrospectively evaluated. Results: Fortyfour patients were treated with Cohen procedure and 2 patients were treated with Leadbetter-Politano procedure. Medical treatment was the first line treatment in all patients except with anatomical disorders such as paraureteral diverticulum and uretorecele. We encountered two relapses. Ureteral obstruction occurred in one patient. We encountered urinary tract infections (UTI) in 11 patients (23.9 %) postoperatively, 9 of them were lower UTI. Ureteral reimplantation was performed in 6 patients with failed subureteric injection. The overall success rate of ureteral reimplantation was 97,5% in this series. Conclusion: Uretereal reimplantation is a reliable method with high success rate in the treatment of patients with VUR

Özet

Amaç: Özellikle düşük ve orta dereceli vezikoüreteral reflüsü (VÜR) olan hastalarda profilaktik antibiyotik tedavisinin denenmesi önerilmektedir. Profilaktik antibiyotik tedavisi başarısız ve anatomik üriner sistem sorunu olan hastaların VÜR'lerinin ameliyat ile düzeltilmesi gerekmektedir. Amacımız VÜR tedavisinde açık ameliyat deneyimlerimizi ve sonuçlarını paylaşmaktır. Gereç ve Yöntem: 1988-2003 yılları arasında açık ameliyatla tedavi edilmiş 2 ay ile 17 yaş arasındaki (ortalama 6,4 yıl) 46 hasta (23 erkek, 23 kız), 77 VÜR'lü üreter retrospektif olarak incelendi. Bulgular: Anatomik bozukluğu olan hastalar dışındaki hastalara öncelikle profilaktik antibiyotik tedavisi uygulandı. Çalışmaya alınan 44 hasta Cohen, 2 hasta Politano-Leadbetter yöntemiyle ameliyat edildi. İki hastada nüks VÜR saptandı. Bir hastada obstruksiyon oluştu. On bir hastada ameliyat sonrası İYE saptandı. Dokuz hastada alt üriner sistem enfeksiyonu şeklindeydi. İlk tedavileri subüreterik enjeksiyon ile yapılmış fakat VÜR'ü engellenememiş 6 hasta açık cerrahi yöntemle tedavi edildi. Açık cerrahi tedavi yöntemiyle % 97.5 başarı sağlandı. Sonuç: VÜR tedavisinde açık ameliyat yöntemi yüksek başarı oranlarıyla güvenilir bir tedavi yöntemidir.

Keywords

Vezikoüreteral reflü Geriyedönük çalışma Ürolojik cerrahi prosedürler Vesico-Ureteral Reflux Retrospective Studies Urologic Surgical Procedures

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Cite This Article

ATEŞ, O., HAKGÜDER, G., ÇAĞLAR, M., KARAKUŞ, O. Z., OLGUNER, M., AKGÜR, F. M. (2006). Vesicoureteral reflux treatment: Ureteroneocystostomy. Çocuk Cerrahisi Dergisi, Cilt: 20 - Sayı: 1, 48–51. https://ajindex.com/articles/160828

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