Vesicoureteral Reflux

Abstract

ABSTRACT… Objectives:The objective of our study is to compare the extravesical and intravesical ureteric reimplantation for the treatment of bilateral vesicoureteral reflux in children. Period: April 2013 and July 2016. Setting: Urology Department of Mayo Hospital, Lahore. Methodology: 66 children diagnosed with primary vesicoureteral reflux and undergoing ureteric reimplantation. The Cohen cross-trigonal reimplantation (intravesical) and modified Lich-Gregoir procedure (extravesical) were performed on two separate groups Group IR and group ER. The following parameters were compared: postoperative duration of stay in the hospital, hematuria and bladder spasm. Frequency of hematuria, bladder spasm and average duration of stay in the hospital were compared in both group. Mean and standard deviation was calculated for age, gender and duration of surgery in both groups.). Chi square test was applied to check the association of outcome variables with demographical variables and duration of surgery. Results: These 100% (n=66) patients were divided into 2 groups equally, 33 in each, i.e. group ER and group IR. The mean age and duration of surgery of the patients of group ER were 13.78±2.83 years, 102.45±4.13 minutes respectively. While the mean age and duration of surgery of the patients of group IR was 30.33±4.58 years and 119.7±10.70 minutes respectively ( Table-II).The main outcome variables of this study were the hospital stay, postoperative bladder spasm and hematuria. The mean hospital stay of the patients of group ER and group IR was 4.30±1.35 days and 5.84±1.0 respectively ( Table-II). It was observed that bladder spasm in group ER and group IR was 39.4% (n=13) and 54.5% (n=18) respectively (Figure-1). It was also observed that hematuria in group ER and group IR was 36.4% (n=12) and 48.5% (n=16) respectively (Figure-2). Conclusion: The observation of this study concludes that extravesical ureteric reimplantation has an edge over conventional procedure of intravesical ureteric approach. Intravesical procedure has disadvantages of more frequency of postoperative complications like, hospital stay, bladder spasms and hematuria. Key words:Vesicoureteral Reflux, Extravesical ureteric reimplantation, Intravesical ureteric reimplantation