Antireflux Surgery at National Surgical Quality Improvement Program-Pediatric Hospitals

Johnson, Emilie K.; Chalmers, David J.; Nelson, Caleb P.; Li, Isaac T. S.; Iwaniuk, Marie; Grant, Catherine; Byrd, Claudia; Rangel, Shawn J.; Saito, Jacqueline M.; Barnhart, Douglas C.; Hall, Bruce L.; Vemulakonda, Vijaya M.; Groth, Travis W.; Ellison, Jonathan S.; Janzen, Nicolette; Hittelman, Adam B.; DiCarlo, Heather; Merguerian, Paul A.; Tanaka, Stacy T.; Prasad, Michaella M.

doi:10.1097/ju.0000000000001439

Cited by 5 publications

(1 citation statement)

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“…Immediate and long-term follow-up resulted in improvement, and no recurring urine incontinence was reported. This corroborates with previous studies that reported that open ureteral re-implantation is still the most common antireflux method with high success rates (Johnson et al, 2021). Antireflux procedure options have expanded to include minimally invasive approaches, which include laparoscopic/robotic reimplantation procedures and endoscopic injections (Johnson et al, 2021).…”

Section: Discussionsupporting

confidence: 90%

Vesicovaginal Fistula Secondary to Left Ectopic Ureter in a 3-Year-Old Female with Left Ureter-Duplication in Tamale Teaching Hospital, Ghana: A Case Report

Wewoli,

Afoko

2024

IJHMNP

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Purpose: Vesicovaginal fistula (VVF) is a pathological connection between the bladder and vagina, primarily caused by gynaecological surgery, obstructed labour, and cesarean section. VVF significantly impairs quality of life and is prevalent in developing countries, with Africa seeing up to 130,000 new cases annually. Surgical repair, especially transvaginal approaches, remains the primary treatment. Paediatric cases of VVF, often linked to congenital anomalies like ectopic ureter, are rare and complex to manage. Methodology: We report a case of a 3-year-old female with continuous urinary leakage since birth, initially flagged for renal anomalies via prenatal imaging. Clinical examination was normal with no distress or developmental issues. Diagnostic assessments, including abdominal ultrasound and micturating cystourethrogram (MCUG), revealed left hydronephrosis, hydroureter, and a definitive vesicovaginal fistula. A CT Urogram confirmed the diagnosis, showing contrast leakage into the vagina. Findings: Diagnostic cystoscopy revealed a normally positioned right ureteric orifice, while the left was aberrantly positioned near the bladder neck. Culposcopy identified a ureterocele in the posterior fornix of the vagina. During laparotomy, a dilated left distal ureter was observed entering the vagina, indicating true ureter duplication. The surgical intervention involved left ureteric reimplantation using the antireflux method, successfully resolving the anomaly. Post-operative recovery was smooth, with significant improvement in urinary symptoms and no recurrence or complications noted during follow-up. Unique contribution to theory, policy and practice: VVF secondary to ectopic ureter in paediatric patients is rare but manageable with early diagnosis and tailored surgical intervention. Our case underscores the importance of a multidisciplinary approach and the efficacy of ureteral reimplantation in treating complex congenital anomalies, leading to favourable outcomes and symptom resolution.

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Section: Discussionsupporting

confidence: 90%