Long-term incidence of urinary tract infection after ureteral reimplantation for primary vesicoureteral reflux

Nelson, Caleb P.; Hubert, Katherine C.; Kokorowski, Paul; Huang, Lin; Prasad, Michaella M.; Rosoklija, Ilina; Retik, Alan B.

doi:10.1016/j.jpurol.2011.12.009

Cited by 21 publications

(14 citation statements)

References 20 publications

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“…Whittam et al [10] in their large series showed UTI rate of 31% and febrile UTI rate of 4.6% after an average follow-up of 15 months and a significant number of these cases had dysfunctional elimination syndrome. In two recently published articles, non-febrile UTI was 15% and 15.6% whereas febrile UTI was 0.6% and 4.1% [11,12]. In our study, the incidence was 7.9% of nonfebrile UTI and 4.9% of febrile UTI.…”

Section: Discussionsupporting

confidence: 52%

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Incidence of Post-Ureteric Reimplantation Urinary Tract Infection in Primary Vesicoureteral Reflux

Mariyappa

Maruthayanar

Samnakay

et al. 2016

World J Nephrol Urol

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Background: The goal of treatment in vesicoureteral reflux (VUR) is to reduce the risk of reflux-associated pyelonephritis. Medical versus surgical treatment for VUR is still controversial, with surgery successful in majority of cases. There are not enough data available in literature on long-term incidence of urinary tract infection (UTI) after reimplantation. The aim of the study was to determine the long-term outcome after reimplantation with respect to UTI, renal scarring and potential risk factors for post-reimplant UTI.

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Section: Discussionsupporting

confidence: 52%

“…Possible risk factors for post-reimplant UTI are female sex, previous breakthrough infection, high grade reflux and pre-operative renal scarring [12]. Recently published Swedish reflux study found that girls with high grade VUR had significantly higher rate of recurrent febrile UTI than boys [19].…”

Section: Discussionmentioning

confidence: 99%

Incidence of Post-Ureteric Reimplantation Urinary Tract Infection in Primary Vesicoureteral Reflux

Mariyappa

Maruthayanar

Samnakay

et al. 2016

World J Nephrol Urol

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“…Actually, the postoperative UTI is not an infrequent event. Postoperative UTI is reported between 20 to 50% of cases (23)(24)(25)(26)(27). In these studies, preoperative grade of reflux, presence of dysfunctional elimination syndrome, presence of renal scar and preoperative BTI were found as causative factors.…”

Section: Discussionmentioning

confidence: 93%

Ureteroneocystostomy in primary vesicoureteral reflux: critical retrospective analysis of factors affecting the postoperative urinary tract infection rates

et al. 2014

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ARTICLE INFO ______________________________________________________________ ______________________Introduction: To determine the parameters affecting the outcome of ureteroneocystostomy (UNC) procedure for vesicoureteral reflux (VUR). Materials and Methods:Data of 398 patients who underwent UNC procedure from 2001 to 2012 were analyzed retrospectively. Different UNC techniques were used according to laterality of reflux and ureteral orifice configuration. Effects of several parameters on outcome were examined. Disappearance of reflux on control VCUG or absence of any kind of UTI/symptoms in patients without control VCUG was considered as clinical improvement.Results: Mean age at operation was 59.2 ± 39.8 months and follow-up was 25.6 ± 23.3 months. Grade of VUR was 1-2, 3 and 4-5 in 17, 79, 302 patients, respectively. Male to female ratio was 163/235. UNC was performed bilaterally in 235 patients and intravesical approach was used in 373 patients. The frequency of voiding dysfunction, scar on preoperative DMSA, breakthrough infection and previous surgery was 28.4%, 70.7%, 49.3% and 22.4%, respectively. Twelve patients (8.9%) with postoperative contralateral reflux were excluded from the analysis. Overall clinical improvement rate for UNC was 92%. Gender, age at diagnosis and operation, laterality and grade of reflux, mode of presentation, breakthrough infections (BTI) under antibiotic prophylaxis, presence of voiding dysfunction and renal scar, and operation technique did not affect the surgical outcome. However, the clinical improvement rate was lower in patients with a history of previous endoscopic intervention (83.9% vs. 94%). Postoperative UTI rate was 27.2% and factors affecting the occurrence of postoperative UTI were previous failed endoscopic injection on univariate analysis and gender, preoperative BTI, postoperative VUR state, voiding dysfunction on multivariate analysis. Surgery related complication rate was 2% (8/398). These were all low grade complications (blood transfusion in 1, hematoma under incision in 3 and prolonged hospitalization secondary to UTI in 4 patients).In long term, 12 patients are under nephrologic follow-up because of hypertension in 5, increased serum creatinine in 5, proteinuria in 1 and hematuria in 1 patient and all these patients had preoperative scarred kidneys. Conclusions: Despite its invasive nature, UNC has a very high success rate with a negligible percent of complications. In our cohort, the only factor that negatively affected the clinical improvement rate was the history of previous antireflux interventions where the predictive factors for postoperative UTI were previous failed endoscopic injection, female gender, preoperative BTI, persistent VUR and voiding dysfunction.

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“…With regard to the selection of treatment in occult VUR, the authors believe that the endoscopic application of bulking agent seems to be a more suitable, minimally invasive therapy in patients with a negative VCUG and positive DMSA scan after recurrent febrile UTIs, as the clinical success rate of endoscopic therapy, in comparison to ureteral reimplantation (in primary VUR), was similarly high (95.8% vs 96.5%) [29]. Therefore, it is important that in such patients, especially infants and young adults, surgical therapy is performed in a minimally invasive way.…”

Section: Discussionmentioning

confidence: 98%

Clinical outcome after endoscopic therapy for occult vesicoureteral reflux in females: preliminary results of a retrospective case series

Pichler

Heidegger

Schlenck

et al. 2014

Scandinavian Journal of Urology

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Long-term incidence of urinary tract infection after ureteral reimplantation for primary vesicoureteral reflux

Cited by 21 publications

References 20 publications

Incidence of Post-Ureteric Reimplantation Urinary Tract Infection in Primary Vesicoureteral Reflux

Incidence of Post-Ureteric Reimplantation Urinary Tract Infection in Primary Vesicoureteral Reflux

Ureteroneocystostomy in primary vesicoureteral reflux: critical retrospective analysis of factors affecting the postoperative urinary tract infection rates

Clinical outcome after endoscopic therapy for occult vesicoureteral reflux in females: preliminary results of a retrospective case series

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