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Impact of Preoperative Filling-Phase Vesicoureteral Reflux on Febrile Urinary Tract Infections After Vesicostomy in

Shinsuke Yoshizawa1, Kensuke Ohashi1

  • 1Department of Pediatric Urology, Saitama Children's Medical Center, Saitama, JPN.

Cureus
|December 18, 2025
PubMed

Insights

Preoperative filling-phase vesicoureteral reflux (VUR) significantly increases the risk of febrile urinary tract infections (fUTIs) after pediatric vesicostomy. Early detection and management of VUR are crucial for preventing recurrent infections in children undergoing this procedure.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Surgical Outcomes

Background:

  • Vesicostomy is a standard urinary diversion for pediatric high-pressure bladders, including those with vesicoureteral reflux (VUR) and neurogenic bladder (NB).
  • Recurrent febrile urinary tract infections (fUTIs) remain a concern post-vesicostomy, impacting patient outcomes.
  • The role of preoperative VUR in predicting postoperative fUTIs requires further clarification.

Purpose of the Study:

  • To determine if preoperative filling-phase VUR on voiding cystourethrography (VCUG) predicts recurrent fUTIs after vesicostomy in children.
  • To identify risk factors associated with postoperative fUTIs following vesicostomy.

Main Methods:

  • Retrospective analysis of 27 pediatric patients undergoing vesicostomy (January 2019 - December 2024).
  • Patients were classified based on the presence or absence of postoperative fUTIs.
  • Clinical data including filling-phase VUR, bladder compliance, detrusor overactivity, posterior urethral valve (PUV), and intrarenal reflux (IRR) were analyzed using chi-squared tests (p<0.05 significance).

Main Results:

  • 17 out of 27 patients (62.9%) developed postoperative fUTIs.
  • Filling-phase VUR was present in 20 patients, with 15 experiencing fUTIs (p=0.03).
  • The odds ratio for filling-phase VUR predicting fUTIs was 7.50; other factors showed no significant association.

Conclusions:

  • Preoperative filling-phase VUR is a significant risk factor for recurrent fUTIs post-vesicostomy in pediatric patients.
  • Children with preoperative filling-phase VUR may benefit from closer monitoring and targeted interventions to prevent infections.
  • Identifying preoperative VUR aids in optimizing management strategies for children undergoing vesicostomy.
Abstract

Keywords:
febrile urinary tract infectionsfilling-phase vurpediatric urology surgeryvesicostomyvesicoureteral reflux

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