Endoscopic correction of vesicoureteral reflux in children with a solitary kidney: The risk of obstruction

Abstract Purpose We aimed to review patients with a solitary kidney and ipsilateral vesicoureteral reflux (VUR) who underwent endoscopic correction of VUR (ECVUR) and to evaluate the prevalence of obstruction in this group of patients. Materials and methods We retrospectively reviewed the files of a...

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Bibliographic Details
Published in:Journal of pediatric urology 2013-12, Vol.9 (6), p.1166-1169
Main Authors: Alenezi, Husain, Alhazmi, Hamdan, Trbay, Mahmoud, Neel, Khalid Fouda
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Dextranomer/hyaluronic acid copolymer
Endoscopy - adverse effects
Endoscopy - statistics & numerical data
Female
Follow-Up Studies
Humans
Hydronephrosis - diagnostic imaging
Hydronephrosis - epidemiology
Hydronephrosis - etiology
Kidney - pathology
Male
Obstruction
Pediatrics
Prevalence
Retrospective Studies
Risk Factors
Solitary kidney
Ultrasonography
Ureteral Obstruction - diagnostic imaging
Ureteral Obstruction - epidemiology
Ureteral Obstruction - etiology
Urologic Surgical Procedures - adverse effects
Urologic Surgical Procedures - statistics & numerical data
Urology
Vesico-Ureteral Reflux - epidemiology
Vesico-Ureteral Reflux - surgery
Vesicoureteral reflux
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Summary:Abstract Purpose We aimed to review patients with a solitary kidney and ipsilateral vesicoureteral reflux (VUR) who underwent endoscopic correction of VUR (ECVUR) and to evaluate the prevalence of obstruction in this group of patients. Materials and methods We retrospectively reviewed the files of all patients who underwent ECVUR at our center between January 2000 and June 2011. Only patients with a solitary kidney and ipsilateral VUR were included. Results Thirteen patients met our criteria. Two patients (15.38%) developed obstruction post-ECVUR. Both patients developed anuria in the first 24 h after surgery and required intervention. Two patients (15.38%) had increasing hydroureteronephrosis that was discovered on follow-up ultrasound, with no symptoms or signs of obstruction. Both were managed conservatively. Conclusion Our results showed a higher percentage of obstruction post-ECVUR in patients with a solitary kidney (15.38%), who required immediate intervention. Thus, we recommend giving clear instructions to parents of patients with VUR and a solitary kidney post-ECVUR before discharge from the hospital regarding decreased urine output and loin pain. We recommend a follow-up ultrasound to rule out obstruction and detect new-onset hydronephrosis.
ISSN:1477-5131
1873-4898
DOI:10.1016/j.jpurol.2013.04.020