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Experience of Maharaj Nakorn Chiang Mai Hospital in extravesical ureteral reimplantation for vesicoureteral reflux in pediatric patients

Wittawat Rawiyotai, Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, Phitsanu Mahawong, Wilaiwan Chongruksut, Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, Center of Surgical Research, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
2021 Insight Urology  

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Objective: The most commonly used technique for vesicoureteral reflux (VUR) treatment in pediatric patients in Maharaj Nakorn Chiang Mai Hospital is extravesical ureteral reimplantation (EUR). This report describes our experience of clinical outcomes of this technique. Materials and Methods: A total of 30 children underwent EUR for unilateral and bilateral VUR between July 2007 and June 2015. We retrospectively reviewed their medical records. Patient characteristics, operative time, duration of
more » ... catheter drainage, length of postoperative hospital stay, and perioperative complications were evaluated. Results: Twenty-two boys and 8 girls with a mean age of 4.4 years (range, 0.5-14.6) were included in the study. Reflux was graded 1 to 5. Fourteen unilateral and 16 bilateral procedures were performed. A Pfannenstiel incision was implemented in the first 20 cases and inguinal incision in the last 10 cases. Mean operative time was 115.5 minutes. Mean duration of catheter insertion was 5.7 days. Mean length of postoperative hospital stay was 6.1 days and mean estimated blood loss was 28.7 ml. Overall success rate was 90%. One patient (3.3%), developed a post- operative urinary tract infection, while 3 cases had persistent VUR after surgery. Acute urinary retention occurred in 1 patient (3.3%) on postoperative day 4 but following catheterization the patient was able to urinate by day 7. Conclusion: EUR for the treatment of VUR is a simple, safe, and effective procedure. The prevalence of postoperative urinary retention in bilateral reimplantation is low and transient. The inguinal approach is a viable option and as effective as classical procedures.
doi:10.52786/isu.a.29 fatcat:esmx37immzg6rjdg2z3wghmdrm
Citation

Wittawat Rawiyotai, Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, Phitsanu Mahawong, Wilaiwan Chongruksut, Division of Urology, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, Center of Surgical Research, Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. "Experience of Maharaj Nakorn Chiang Mai Hospital in extravesical ureteral reimplantation for vesicoureteral reflux in pediatric patients." Insight Urology 42.2 (2021) 90-96