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Refluxing ureteral stump

T Krarup, H Wolf

    Scandinavian Journal of Urology and Nephrology
    |January 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Recurrent urinary tract infections can stem from urine reflux into a remaining ureter after kidney removal. Complete ureter removal is advised for severe reflux cases to prevent recurring infections.

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    Area of Science:

    • Urology
    • Nephrology
    • Pediatric Surgery

    Background:

    • Recurrent urinary tract infections (UTIs) pose a significant clinical challenge, particularly in cases involving unilateral renal pathology.
    • Chronic pyelonephritis, often necessitating surgical intervention like nephrectomy, requires thorough pre-operative assessment to identify potential complications.

    Observation:

    • Two pediatric cases presented with recurrent UTIs attributed to vesicoureteral reflux (VUR) into a residual ureter following nephrectomy.
    • These cases highlight a potential, yet often overlooked, source of persistent infection post-nephrectomy.

    Findings:

    • Voiding cysto-urethrogram (VCUG) is crucial in the pre-operative evaluation for patients undergoing nephrectomy for unilateral chronic pyelonephritis.
    • The presence of significant VUR into a residual ureter mandates consideration for complete ureteral excision alongside the kidney to resolve recurrent UTIs.

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    Implications:

    • Integrating VCUG into the standard workup for unilateral nephrectomy can prevent recurrent UTIs and associated morbidity.
    • Complete ureteric resection in cases of severe reflux may be a necessary adjunct to nephrectomy for optimal patient outcomes.