Related Experiment Videos

Is long-term sonographic followup necessary after uncomplicated ureteral reimplantation in children?

Stephen G Charbonneau1, Leslie D Tackett, Eileen Hodge Gray

  • 1Tulane University School of Medicine, New Orleans, Louisiana, USA.

The Journal of Urology
|September 8, 2005
PubMed

Insights

Postoperative ultrasound for children after vesicoureteral reflux surgery is unnecessary beyond one year. This follow-up can be eliminated to significantly reduce healthcare costs.

Area of Science:

  • Pediatric Urology
  • Surgical Outcomes Research

Background:

  • Vesicoureteral reflux (VUR) is common in children, often requiring surgical correction.
  • Current postoperative monitoring guidelines for VUR surgery lack standardization, leading to varied follow-up protocols.
  • Long-term surveillance for complications like hydronephrosis, renal scarring, and growth is inconsistently applied.

Purpose of the Study:

  • To evaluate the necessity of prolonged postoperative ultrasound surveillance after ureteral reimplantation for VUR.
  • To determine if routine imaging beyond the initial postoperative period is warranted for uncomplicated cases.

Main Methods:

  • Retrospective chart review of 128 children who underwent surgical correction for primary VUR between 1992 and 2002.
  • Data collected included patient demographics, reflux grade, surgical details, and postoperative outcomes (voiding cystourethrograms, ultrasounds, infections, symptoms).
  • Analysis focused on the resolution of reflux, changes in hydronephrosis, and development of new complications.

Main Results:

  • Postoperative reflux was identified in 4 patients, all of whom showed resolution or stability.
  • 17 patients had grade 2-3 hydronephrosis at 3 months, with stable or improved findings on subsequent ultrasounds.
  • No new hydronephrosis or worsening of existing hydronephrosis was observed beyond the 1-year postoperative ultrasound.

Conclusions:

  • Routine postoperative ultrasound follow-up for children with uncomplicated ureteral reimplantation is not necessary beyond one year.
  • Discontinuing surveillance after one year can lead to substantial cost savings in pediatric healthcare.
  • This finding supports a more streamlined approach to VUR surgical follow-up.
Abstract

Related Concept Videos

Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
Imaging Studies II: Ultrasonography01:24

Imaging Studies II: Ultrasonography

IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...