Surgical Management of Primary Vesicoureteral Reflux
Keywords:Surgical Management, Primary Vesicoureteral Reflux
Objective: To collect and evaluate result of surgical management of severe primary vesicoureteral reflux (VUR) in pediatric patients at Prapokklao Hospital, Chantaburi.
Material and method: Collection of pediatric patients with severe grade of primary vesicoureteral reflux at surgical department between 2000-2005 were reviewed. Age, sex, type of VUR, presenting symptoms, radiologic finding and operative techniques were reviewed.
Results: There were 22 cases, 14 girls and 8 boys with primary, severe grade VUR. Thirteen cases had unilateral VUR and 9 cases had bilateral VUR. Presenting symptoms were recurrent UTI (100%), urosepsis (9%), abnormal urination (23%), palpable kidney (4%), failure to thrive (4%). Surgical procedures in unilateral VUR were Politano-Lead better ureteroneocystostomy 3 cases, Glenn-Anderson reimplantation 10 cases. In cases of bilateral VUR, Cohen-cross trigone reimplantation were used in 9 cases. Primary VUR with megaureter were found in 3 cases, tapering of lower end ureter with reimplantation were performed in 2 cases and in 1 case tapering of the whole ureter with reimplantation was performed.
Conclusion: In severe grade VUR (gr.V) and bilateral VUR, surgical reimplantation of ureters were considered. The results were excellent and complication was minor.
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