Unilateral extravesical ureteral reimplantation via inguinal incision for the correction of vesicoureteral reflux: a 10-year experience
Int. braz. j. urol
;
43(5): 917-924, Sept.-Oct. 2017. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-892885
ABSTRACT
ABSTRACT Introduction and Objective: Multiple options exist for the surgical management of vesicoureteral reflux (VUR). We report on our 10-year experience using the inguinal approach to extravesical ureteral reimplantation (EVR). Materials and Methods: Patient characteristics of age, gender, and reflux grade were obtained and outcomes of operative time, hospital stay, and radiographic resolution were assessed. Results: 71 girls and 20 boys with a mean age of 74 months (range 14-164) underwent inguinal EVR via a 3.5-cm inguinal mini-incision. Mean follow up was 10.9 months (range 0.4-69.7). Average grade of reflux was 2.80. Average operative time was 91 minutes (range 51-268). The procedure was successful in 87 of 91 patients (95.6%). The 3 cases of reflux that persisted were all grade 1 and managed expectantly. Contralateral reflux developed in 9 cases, all of which resolved after treatment with either Deflux or ureteral reimplant. There were 4 case of urinary retention that resolved after a brief period of CIC or indwelling catheterization. There were no cases of ureteral obstruction. Most patients were discharged on post-operative day 1 (85/91) and no hospitalization extended beyond 3 days. Conclusions: The inguinal approach to extravesical ureteral reimplantation should be considered as a potentially minimally invasive alternative to endoscopic and robotic treatment of VUR with a success rate more comparable to traditional open approaches. We feel it is the method of choice in cases of unilateral VUR requiring surgical correction.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Reimplantación
/
Procedimientos Quirúrgicos Urológicos
/
Uréter
/
Reflujo Vesicoureteral
Tipo de estudio:
Estudio de etiología
/
Estudio de incidencia
/
Estudio observacional
/
Factores de riesgo
Límite:
Adolescente
/
Niño
/
Child, preschool
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Int. braz. j. urol
Asunto de la revista:
Urología
Año:
2017
Tipo del documento:
Artículo
País de afiliación:
Estados Unidos
Institución/País de afiliación:
Rady Children's Hospital/US
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