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[Antireflux surgery in infants with vesicoureteral reflux]

M Gakiya1, Y Ogawa

  • 1Department of Urology, Okinawa Prefectural Hospital, Miyako.

Hinyokika Kiyo. Acta Urologica Japonica
|May 12, 2000
PubMed

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.

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