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[Antireflux surgery in infants with vesicoureteral reflux]
Insights
Early surgery for febrile urinary tract infections (UTI) in infants with high-grade vesicoureteral reflux (VUR) can prevent recurrence. This study found VUR resolved within a year post-operation, suggesting benefits for selected infants.
Area of Science:
- Pediatric Urology
- Infectious Diseases
- Surgical Innovation
Background:
- Febrile urinary tract infections (UTI) are a significant concern in infants.
- Vesicoureteral reflux (VUR) is a common underlying condition that can lead to recurrent UTIs and renal damage.
- Identifying and treating high-grade VUR in infants is crucial for preventing long-term complications.
Purpose of the Study:
- To evaluate the efficacy of early antireflux surgery in infants experiencing febrile UTIs.
- To assess the outcomes of surgical intervention for high-grade VUR in this pediatric population.
- To explore the benefits and challenges of surgical management for VUR in infants.
Main Methods:
- A cohort of five infants (four boys, one girl) admitted with febrile UTI was studied.
- Diagnostic cystoscopy and X-ray imaging were performed to identify VUR.
- Patients with high-grade VUR underwent antireflux surgery using modified Amar-Paquin or Politano-Leadbetter techniques.
Main Results:
- All five infants presented with febrile UTI at an average age of 1.3 months.
- All patients exhibited high-grade VUR requiring surgical correction.
- Post-surgery, no UTIs recurred, and VUR resolved within one year with no reported complications.
Conclusions:
- Early surgical intervention for selected infants with high-grade VUR appears beneficial, leading to UTI resolution and VUR disappearance.
- The study highlights the positive outcomes of antireflux surgery in this pediatric cohort.
- Surgical techniques and management strategies for infants, particularly those with severe ureteral dilation, remain subjects of ongoing debate and research.
Abstract:
Febrile urinary tract infections (UTI) resulted in the admission of five infants (four boys, one girl) to Okinawa Prefectural Hospital in Miyako. The first febrile episode developed at an average age of 1.3 months. All patients underwent cystoscopy and X-ray studies to role out secondary causes for vesicoureteral reflux (VUR). All patients had high grade reflux and underwent antireflux surgery using a modification of the Amar-Paquin method or the Politano-Leadbetter method. They tolerated the procedures without any complications. No UTI recurred and VUR disappeared in one year following surgery. Early surgical intervention seems beneficial for selected infants with high grade VUR, but the surgical procedure and methods for infants, especially those with severe dilated ureter, are still controversial.