[Clinical evaluation of vesicoureteroneostomy. I. Efficacy of surgery in 65 cases (100 ureters) of primary vesicoureteral reflux].
We have experienced 72 patients with primary vesicoureteral reflux (VUR) during the past 16 years. Sixty-five of them (100 ureters) were treated surgically to prevent reflux. Among the surgical methods employed, the Politano-Leadbetter method was the most frequent, being used in 56 patients (87 ureters). Other methods were the combined method in 2 patients (three ureters), the Glenn-Anderson method in 1 (2 ureters), the Cohen method in 1 (1 ureter) and the Lich-Gregoir method in 5 patients (7 ureters). As postoperative complications in the early stage (within 1 month after surgery), remaining VUR in 1 ureter in 1 of the patients who underwent surgery by the Politano-Leadbetter method and occurrence of VUR on the contralateral side in 3 patients with unilateral VUR were encountered. These conditions disappeared during the follow-up period. On the other hand, in the late postoperative stage, ureteral stenosis requiring further surgery occurred in 1 ureter in the transitional region to the urinary bladder in 1 patient 2 months after surgery by the Lich-Gregoir method. The rate of success was all 87 ureters (100%) for the Politano-Leadbetter method and 6 out of 7 ureters (85.7%) for the Lich-Gregoir method. The success rates for the other procedures were also good, resulting in an overall rate of 99 out of 100 ureters (99.0%). Ninety-nine percent of the patients had been treated at least once preoperatively for pyelonephritis or fever of unknown etiology. Among these patients, those who had had 5 or more such episodes accounted for 39%.(ABSTRACT TRUNCATED AT 250 WORDS)
Saito
S
S
Department of Urology, Sapporo Medical College, School of Medicine.
Kumamoto
Y
Y
Hirose
T
T
Tsukamoto
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011704:Pyelonephritis / Q000150:complications; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014718:Vesico-Ureteral Reflux / Q000145:classification / Q000150:complications / Q000601:surgery*