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Lower urinary tract dysfunction in children after intravesical ureteric reimplantation surgery under one year of age
1Princess Margaret Hospital for Children, Roberts Road, Subiaco, Western Australia 6008, Australia.
Insights
Children undergoing early intravesical Cohen ureteric reimplantation surgery show normal lower urinary tract (LUT) function rates comparable to the general pediatric population. This study assessed voiding function in young children post-surgery.
Area of Science:
- Pediatric Urology
- Urologic Surgery
Background:
- Intravesical trans-trigonal Cohen ureteric reimplantation is a surgical procedure for vesicoureteral reflux.
- Assessing long-term voiding function after early childhood surgery is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the voiding function in children who underwent intravesical Cohen ureteric reimplantation before one year of age.
- To determine if early surgery impacts lower urinary tract (LUT) function compared to the general pediatric population.
Main Methods:
- A cohort of 28 children (mean age at surgery 4.9 months) was assessed for bladder function at a mean age of 7.3 years.
- Assessments included questionnaires, dysfunctional voiding scoring system, quality of life tools, uroflowmetry, and post-void residuals.
Main Results:
- 72% of children demonstrated normal lower urinary tract (LUT) function post-surgery.
- 28% exhibited LUT dysfunction, including urge incontinence, giggle incontinence, voiding postponement, and dysfunctional elimination syndrome.
- Management strategies included continence physiotherapy (urotherapy) and anticholinergic therapy for some patients.
Conclusions:
- The incidence of bladder dysfunction in children who underwent intravesical Cohen ureteric reimplantation before one year of age is not higher than in the general pediatric population.
- Early intravesical Cohen ureteric reimplantation surgery does not appear to adversely affect long-term voiding function.
Objective:
To report the results of a study conducted on voiding function in children who have undergone intravesical trans-trigonal Cohen ureteric reimplantation surgery before the age of one year.
Subjects:
Twenty-eight children (18 males, 10 females) had surgery at a mean age of 4.9 months (range 8-352 days).
Methods:
Bladder function was assessed at a mean age of 7.3 years using questionnaires, the dysfunctional voiding scoring system, PinQ quality of life tool, uroflowmetry and post-void residuals.
Results:
Of the total children, 72% had normal lower urinary tract (LUT) function. Eight children (28%) had evidence of LUT dysfunction, two had urge incontinence, two had giggle incontinence, two had voiding postponement, one had dysfunctional elimination syndrome and one had evidence of dysfunctional voiding. Five of the eight children were managed with continence physiotherapy (urotherapy) and one required ongoing anticholinergic therapy.
Conclusion:
When compared to the published rates of LUT dysfunction in the general paediatric community, no evidence was found to suggest an increased incidence of bladder dysfunction in children undergoing intravesical Cohen ureteric reimplantation surgery under one year of age.
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