title: Extravesical nondismembered ureteroplasty with detrusorrhaphy: a renewed technique to correct vesicoureteral reflux in children.
abstract: We performed an extravesical nondismembered reimplant to correct surgically primary vesicoureteral reflux in 45 patients (65 renal units) between April 1989 and September 1990. Of the units 6 had grade I reflux, 16 grade II, 23 grade III, 14 grade IV and 6 grade V. Only patients with primary reflux were included in this study. The success rate was 100% for grades I to III, 92.9% for grade IV and 66.7% for grade V. Overall, the reflux was cured in 62 of the 65 operated renal units (95.4%) or 95.6% of the patients (43 of 45). Postoperative morbidity and complications were minimal. No cases of postoperative obstruction were detected on excretory urography 6 weeks postoperatively. Seven children (16%) suffered from transient inadequate bladder emptying as assessed by post-void ultrasound residual evaluations. This problem resolved spontaneously after a maximum of 4 weeks of clean intermittent catheterization. Compared to conventional transvesical technique, the discomfort related to bladder spasms during the postoperative period was subjectively decreased and patients had no prolonged hematuria.
authors.affiliation: Department of Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: A M
authors.initials: AM
authors.lastname: Houle
authors.forename: G A
authors.initials: GA
authors.lastname: McLorie
authors.forename: D M
authors.initials: DM
authors.lastname: Heritz
authors.forename: P H
authors.initials: PH
authors.lastname: McKenna
authors.forename: B M
authors.initials: BM
authors.lastname: Churchill
authors.forename: A E
authors.initials: AE
authors.lastname: Khoury
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D011182:Postoperative Care; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014718:Vesico-Ureteral Reflux / Q000601:surgery*