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Contralateral reflux after unilateral ureteral reimplantation in patients with a history of resolved contralateral
1Department of Urology, Cleveland Clinic Children's Hospital, Ohio, USA.
Insights
Children with resolved contralateral reflux undergoing unilateral ureteral reimplantation face a high risk of recurrence. Bilateral reimplantation may be a better option for these patients.
Area of Science:
- Pediatric Urology
- Surgical Outcomes
- Reflux Management
Background:
- Primary vesicoureteral reflux (VUR) is common in children.
- Unilateral ureteral reimplantation is a standard surgical treatment for VUR.
- The risk of contralateral VUR recurrence after unilateral surgery in specific patient groups is not well-defined.
Purpose of the Study:
- To determine the risk of contralateral reflux after unilateral ureteral reimplantation.
- To evaluate this risk in patients with a history of resolved contralateral reflux.
Main Methods:
- Retrospective review of 53 children undergoing unilateral ureteral reimplantation for primary VUR.
- Analysis of preoperative and postoperative reflux status.
- Stratification based on history of contralateral reflux.
Main Results:
- Contralateral reflux post-surgery occurred in 45% (5/11) of children with prior resolved contralateral reflux.
- In contrast, only 10% (4/42) of children without a history of contralateral reflux developed postoperative contralateral reflux.
- This indicates a significantly higher risk in the group with a history of resolved contralateral reflux.
Conclusions:
- Children with unilateral VUR and a history of resolved contralateral reflux have a substantial risk of developing contralateral reflux after unilateral reimplantation.
- Bilateral ureteral reimplantation should be strongly considered in these patients to prevent recurrent VUR.
- This approach may improve long-term outcomes and reduce the need for re-intervention.
Purpose:
We determined the risk of contralateral reflux after unilateral ureteral reimplantation in patients with a history of resolved contralateral reflux.
Materials And Methods:
We reviewed our experience with 53 children who underwent unilateral ureteral reimplantation for primary vesicoureteral reflux.
Results:
Postoperative contralateral reflux occurred in 5 of 11 children (45%) with a history of bilateral reflux that had resolved preoperatively on the contralateral side and 4 of 42 (10%) with no history of contralateral reflux.
Conclusions:
Strong consideration should be given to performing bilateral ureteral reimplantation in children with unilateral reflux and a history of resolved contralateral reflux.