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Updated: Aug 19, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Analysis of the long-term outcome of surgically corrected vesico-ureteric reflux
1Department of Urology, The Chaim-Sheba Medical Center, Affiliated to Tel Aviv University, Israel. morna@qbi.co.il
Insights
Children treated for vesico-ureteric reflux with ureteric reimplantation may still face long-term issues. Recurrent urinary tract infections, renal scarring, and pregnancy complications are noted, highlighting the need for ongoing patient monitoring.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Outcomes
Background:
- Vesico-ureteric reflux (VUR) is a common condition in children.
- Ureteric reimplantation is a standard surgical correction for VUR.
- Long-term outcomes after childhood VUR surgery require further investigation.
Purpose of the Study:
- To assess the long-term urological and renal outcomes in patients who underwent ureteric reimplantation for VUR during childhood.
- To evaluate the incidence of late urinary tract infections, renal function, hypertension, and pregnancy complications post-surgery.
Main Methods:
- Retrospective review of 100 patients (322 initially treated between 1970-1979) who had ureteric reimplantation for VUR in childhood.
- Data collected via questionnaires, medical record review, and outpatient clinic appointments.
- Assessment focused on urinary tract infections, renal function, hypertension, pregnancy complications, and new renal scarring at least 20 years post-surgery.
Main Results:
- 51% of patients experienced no long-term urological complications; however, 43% of women and 24% of men reported UTIs.
- New renal scars developed in 20% of patients. Hypertension was found in 6% of patients.
- Pregnancy complications included UTIs (28%), pre-eclampsia (7%), and transient ureteric obstruction. Two patients developed end-stage renal disease.
Conclusions:
- Childhood ureteric reimplantation for VUR does not guarantee freedom from long-term complications.
- Patients remain susceptible to recurrent UTIs, progressive renal scarring, hypertension, and pregnancy-related issues.
- A structured long-term follow-up protocol is essential for these patients.
Objective:
To review patients who had vesico-ureteric reflux corrected surgically by ureteric reimplantation during childhood, and thus assess their long-term outcome.
Patients And Methods:
Between 1970 and 1979, 322 children underwent ureteric reimplantation; 100 (79 women and 21 men) were re-assessed and the long-term results evaluated using a questionnaire, a review of the patients' current medical records and an appointment in the outpatient clinic. The evaluation focused on the frequency of late urinary tract infections (UTIs), current renal function tests, related complications during pregnancy and the incidence of hypertension at least 20 years after surgery.
Results:
Of the study group, 51% (66% of men and 47% of women) had no long-term urological complications. The incidence of UTIs was 43% in women and 24% in men, and of pyelonephritis 27% and 9.5%, respectively. Hypertension was detected in 6% of the patients during assessment. There were new renal scars, despite surgery, in 20% of the patients. Forty-seven women had been pregnant, 28% reporting UTIs during pregnancy. In 7% of 94 pregnancies the women also had pre-eclampsia and two women had transient gestational ureteric obstruction which required drainage. Renal functional tests were worse in one man and one woman who developed end-stage renal disease and had a renal transplant.
Conclusions:
This series shows that even patients who were treated successfully by ureteric reimplantation during childhood are prone to recurrent UTIs, progressive renal scarring, hypertension and complications during pregnancy. There is a need to establish a protocol for the long-term follow-up of such patients.
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