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Lessons learned about contralateral reflux after unilateral extravesical ureteral advancement in children
D K Burno1, D B Glazier, M R Zaontz
1Section of Pediatric Urology, Children's Regional Hospital at Cooper Hospital-University Medical Center, Camden, New Jersey, USA.
The Journal of Urology
|August 27, 1998
Summary
Contralateral reflux after unilateral antireflux surgery in children often resolves with conservative management. Bilateral reimplantation is not recommended for unilateral reflux with a history of resolved contralateral reflux.
Area of Science:
- Pediatric Urology
- Surgical Outcomes
- Reflux Management
Background:
- Contralateral reflux following unilateral antireflux surgery presents diagnostic and management challenges.
- Understanding the natural history and resolution patterns of contralateral reflux is crucial.
Purpose of the Study:
- To evaluate the incidence and resolution of contralateral reflux after unilateral extravesical ureteral advancement in children.
- To inform management strategies for children undergoing unilateral antireflux surgery.
Main Methods:
- Retrospective review of pediatric patients who underwent unilateral extravesical ureteral advancement over a 7-year period.
- Analysis of new-onset and recurrent contralateral reflux, including resolution rates with observation.
Main Results:
- Contralateral reflux developed in 11.6% of patients post-unilateral reimplantation.
- New-onset contralateral reflux resolved in one child with observation.
- Among children with a history of resolved contralateral reflux, recurrence was observed, but most cases resolved conservatively.
Conclusions:
- Recurrent contralateral reflux after unilateral reimplantation typically resolves with conservative management.
- Bilateral reimplantation is not indicated for unilateral reflux with a history of resolved contralateral reflux.
- Observation is the recommended approach for recurrent contralateral reflux, as it is likely to resolve spontaneously.