What Imaging Studies Are Necessary to Determine Outcome After Ureteroneocystostomy?

Abstract

No AccessJournal of UrologyReflux1 Sep 1997What Imaging Studies Are Necessary to Determine Outcome After Ureteroneocystostomy? M. David Bomalaski, Michael L. Ritchey, and David A. Bloom M. David BomalaskiM. David Bomalaski , Michael L. RitcheyMichael L. Ritchey , and David A. BloomDavid A. Bloom View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)64436-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: After ureteroneocystostomy we have performed renal ultrasonography within the first 3 months to exclude hydronephrosis, voiding cystography after 3 months to exclude vesicoureteral reflux and subsequent ultrasonography to monitor the upper tracts. This study attempted to determine those patients at risk for hydronephrosis or recurrent vesicoureteral reflux. Materials and Methods: We studied the records of patients who underwent ureteroneocystostomy in the last decade at our institutions to find the incidence and degree of preoperative and postoperative hydronephrosis and vesicoureteral reflux. Results of initial postoperative imaging were compared to radiological imaging throughout followup (mean 2.3 years). Patients with postoperative reflux were evaluated for risk factors that differentiated them from others. Results: Excluding patients with neuropathic bladder or ureterocele, 167 underwent 278 ureteroneocystostomies at a mean followup of 26.5 months. Persistent vesicoureteral reflux was noted in 4 kidneys (1.4%) and contralateral reflux developed in 3 of the 48 cases (6.3%) of unilateral ureteroneocystostomy. There was no statistical difference in success rates among cross-trigonal, ureteral advancement or extravesical techniques. New onset mild hydronephrosis in 13 kidneys (4.7%) at the initial followup study (mean 1.6 months) completely resolved in 12 and remained mild in 1. No patient had progression of existing hydronephrosis and 1 had recurrent vesicoureteral reflux after initial negative cystography. Risk factors for postoperative reflux or hydronephrosis were preoperative dysfunctional voiding, preoperative hydronephrosis or scarring on sonography and postoperative urinary tract infection. None of the 88 patients without these risk factors had postoperative hydronephrosis or reflux. All patients with persistent, contralateral or recurrent reflux were selected using these criteria (p <0.003). Conclusions: Complication rates after nontapered ureteroneocystostomy in children without neuropathic bladder are quite low. Mild postoperative hydronephrosis was not clinically significant in our patients. 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Google Scholar From the Section of Pediatric Urology, University of Michigan, Ann Arbor, Michigan, and Department of Pediatric Surgery, University of Texas, Houston, Texas.© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLee Y, Im Y, Jung H, Hah Y, Hong C and Han S (2011) Does Hydronephrosis After Extravesical Ureteral Reimplantation Deteriorate Renal Function?Journal of Urology, VOL. 187, NO. 2, (670-675), Online publication date: 1-Feb-2012.Callaghan K, Gray E, Caldamone A and Ellsworth P (2008) Factors Involved in Parental Decision Making for Surgical Correction of Vesicoureteral RefluxJournal of Urology, VOL. 180, NO. 2, (701-706), Online publication date: 1-Aug-2008.Palmer L (2008) The Role of Intraoperative Cystography Following the Injection of Dextranomer/Hyaluronic Acid CopolymerJournal of Urology, VOL. 179, NO. 3, (1118-1121), Online publication date: 1-Mar-2008.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.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.HERNDON C, DeCAMBRE M and McKENNA P (2018) CHANGING CONCEPTS CONCERNING THE MANAGEMENT OF VESICOURETERAL REFLUXJournal of Urology, VOL. 166, NO. 4, (1439-1443), Online publication date: 1-Oct-2001.HERNDON C, FERRER F and McKENNA P (2018) SURVEY RESULTS ON MEDICAL AND SURGICAL FOLLOWUP OF PATIENTS WITH VESICOURETERAL REFLUX FROM AMERICAN ASSOCIATION OF PEDIATRICS, SECTION ON UROLOGY MEMBERSJournal of Urology, VOL. 165, NO. 2, (559-563), Online publication date: 1-Feb-2001.BARRIERAS D, LAPOINTE S, REDDY P, WILLIOT P, McLORIE G, B|fGLI D, KHOURY A and MERGUERIAN P (2018) ARE POSTOPERATIVE STUDIES JUSTIFIED AFTER EXTRAVESICAL URETERAL REIMPLANTATION?Journal of Urology, VOL. 164, NO. 3 Part 2, (1064-1066), Online publication date: 1-Sep-2000.EL-GHONEIMI A, ODET E, LAMER S, BAUDOUIN V, LOTTMANN H and AIGRAIN Y (2018) CYSTOGRAPHY AFTER THE COHEN URETEROVESICAL REIMPLANTATION: IS IT NECESSARY AT A TRAINING CENTER?Journal of Urology, VOL. 162, NO. 3 Part 2, (1201-1202), Online publication date: 1-Sep-1999. Volume 158Issue 3September 1997Page: 1226-1228 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information M. David Bomalaski More articles by this author Michael L. Ritchey More articles by this author David A. Bloom More articles by this author Expand All Advertisement PDF downloadLoading ...