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Voiding dysfunction after bilateral extravesical detrusorrhaphy

E Minevich1, D Aronoff, J Wacksman

  • 1Division of Pediatric Urology, Children's Hospital Medical Center, University of Cincinnati, Ohio, USA.

The Journal of Urology
|August 27, 1998
PubMed
Summary

Bilateral extravesical detrusorrhaphy is a successful procedure for vesicoureteral reflux. Postoperative voiding dysfunction is uncommon and usually temporary, with a low morbidity rate.

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Area of Science:

  • Pediatric Urology
  • Surgical Techniques
  • Voiding Dysfunction

Background:

  • Extravesical detrusorrhaphy is effective for unilateral vesicoureteral reflux.
  • Concerns exist regarding its use in bilateral cases due to potential voiding dysfunction.

Purpose of the Study:

  • To review the incidence of voiding dysfunction after bilateral extravesical detrusorrhaphy.
  • To assess the safety and efficacy of this surgical approach for bilateral ureteral reimplantation.

Main Methods:

  • A retrospective review of 123 patients (231 renal units) who underwent bilateral extravesical detrusorrhaphy between 1990 and 1995.
  • Exclusion of patients requiring anticholinergic therapy or intermittent catheterization at surgery.

Main Results:

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  • A 98.3% success rate in correcting vesicoureteral reflux with no upper urinary tract obstruction.
  • Postoperative voiding dysfunction occurred in 6.5% of patients, with 2.5% experiencing transient irritative symptoms and 4% requiring temporary catheterization.
  • No significant long-term morbidity was observed.

Conclusions:

  • Bilateral extravesical detrusorrhaphy is a highly successful procedure with a low incidence of significant voiding dysfunction.
  • When voiding dysfunction occurs, it is typically transient and of minimal morbidity.
  • Younger patients and those with a prior history of voiding dysfunction may have an increased risk.