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Surgical results: International Reflux Study in Children--United States branch
J W Duckett1, R D Walker, R Weiss
1Division of Urology, Children's Hospital of Philadelphia.
Insights
Surgical correction for pediatric vesicoureteral reflux (VUR) showed satisfactory outcomes with no obstructions. Most patients experienced successful reflux resolution, demonstrating the efficacy of surgical intervention in children.
Area of Science:
- Pediatric Urology
- Surgical Intervention
- Reflux Management
Background:
- Vesicoureteral reflux (VUR) is a common condition in children.
- Surgical correction is a primary treatment modality for VUR.
- The International Reflux Study in Children provided data on surgical outcomes.
Purpose of the Study:
- To evaluate the outcomes of surgical correction for pediatric vesicoureteral reflux.
- To assess the safety and efficacy of different surgical techniques.
- To report on postoperative complications and long-term follow-up.
Main Methods:
- Retrospective analysis of 87 pediatric patients undergoing surgical correction for VUR.
- Review of surgical techniques including Cohen and Politano-Leadbetter reimplantation.
- Analysis of patient demographics, surgical approaches, and follow-up data.
Main Results:
- Satisfactory results with no obstructions were reported in the majority of patients.
- Bilateral reimplantation was performed in 80% of cases.
- Postoperative reflux resolved in all but one ureter, with an average follow-up of 3.9 years.
Conclusions:
- Surgical correction of pediatric vesicoureteral reflux is effective and safe.
- The study highlights the successful outcomes achieved by experienced pediatric urology surgeons.
- Low rates of persistent reflux and obstruction indicate favorable long-term results.
Abstract:
A total of 87 patients in the United States underwent surgical correction of vesicoureteral reflux as part of the International Reflux Study in Children. Of the 66 patients randomized to surgical treatment 2 were transferred to the medical group before surgery was performed, while 23 patients originally assigned to receive medical management ultimately underwent surgery. Of the patients 17 (20%) were less than 1 year old, while the remaining children were evenly distributed by age in 2-year intervals up to age 9 years. Reimplantation was performed by the Cohen technique in 52% and by the Politano-Leadbetter technique in 28% of the patients. Bilateral reimplantation was done in 70 patients (80%). The results were satisfactory, with no obstructions. In 81% of the patients average followup was 3.9 years, although followup of less than 1 year in 19% was satisfactory to determine obstruction. Only 3% of the children were lost to followup. Postoperative reflux, which was noted in 5 patients, resolved in all but 1 ureter. These results reflect the experience of senior surgeons in pediatric urology.