Abstract | PURPOSE: MATERIALS AND METHODS: The records were analyzed of all patients from 2003 to 2007 with unilateral vesicoureteral reflux who underwent mini-ureteroneocystostomy or dextranomer/hyaluronic acid copolymer injection. Mini-ureteroneocystostomy was performed via a 2 cm inguinal incision. Of the injections 66% were delivered via an intraureteral tunnel technique. Statistical analysis was done to compare differences in clinical features and success rates. All p values were 2-sided with significance at p <0.05. RESULTS: From 2003 to 2007, 99 children underwent operative repair of unilateral vesicoureteral reflux, including 42 via dextranomer/hyaluronic acid copolymer injection and 57 via mini-ureteroneocystostomy. There were no significant differences between the groups in terms of preoperative clinical or anatomical variables except for higher preoperative reflux grade in the mini-ureteroneocystostomy cohort (p <0.001). Patients undergoing mini-ureteroneocystostomy were more likely to be cured (100% vs 78%, p = 0.001). De novo contralateral vesicoureteral reflux occurred in the 2 cohorts to a similar degree (p = 0.15). The injection cohort was more likely to be discharged home on an outpatient basis (100% vs 82%, p = 0.002). No complications occurred in the dextranomer/hyaluronic acid copolymer cohort, while 2 children required intervention for complications after mini-ureteroneocystostomy. CONCLUSIONS: This study details that the 2 procedures may be successfully performed in the outpatient setting, and yet even for more advanced vesicoureteral reflux mini-ureteroneocystostomy achieves greater overall success. This procedure has become our standard of care for unilateral vesicoureteral reflux.
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Authors | Richard Ashley, David Vandersteen |
Journal | The Journal of urology
(J Urol)
Vol. 180
Issue 4 Suppl
Pg. 1611-3; discussion 1614
(Oct 2008)
ISSN: 1527-3792 [Electronic] United States |
PMID | 18710741
(Publication Type: Journal Article)
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Chemical References |
- Dextrans
- deflux
- Hyaluronic Acid
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Topics |
- Adolescent
- Child
- Child, Preschool
- Cystostomy
(methods)
- Dextrans
(administration & dosage)
- Female
- Humans
- Hyaluronic Acid
(administration & dosage)
- Infant
- Injections
- Male
- Minimally Invasive Surgical Procedures
- Prostheses and Implants
- Treatment Outcome
- Ureter
(surgery)
- Vesico-Ureteral Reflux
(surgery, therapy)
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