[Pyelo-ureteral duplication and vesico-ureteral reflux]

Area of Science:

• Pediatric Urology
• Nephrology

Background:

• Vesico-ureteric reflux (VUR) is a common condition in children, potentially leading to kidney damage.
• Double upper urinary tracts present unique challenges in managing VUR.

Purpose of the Study:

• To evaluate the outcomes of various treatment protocols for VUR in children with double upper urinary tracts.
• To compare the efficacy of medical management, nephrectomy, and surgical techniques like Cohen's ureterocystoneostomy.

Main Methods:

• Retrospective analysis of 106 children (76 girls, 30 boys) treated for VUR in double upper urinary tracts.
• Review of outcomes associated with medical treatment, partial/total nephrectomy, and Cohen's "en bloc" ureterocystoneostomy.

Main Results:

• Medical treatment demonstrated limited success rates.
• Nephrectomy was sometimes required due to severe renal dysfunction.
• Cohen's technique effectively addressed reflux but resulted in unsatisfactory outcomes due to renal scarring and persistent urinary infections.

Conclusions:

• Surgical intervention, particularly Cohen's ureterocystoneostomy, offers the best conservative approach for VUR in this patient group.
• Despite successful reflux management, long-term renal health remains a concern due to potential scarring and infection post-surgery.