[Persistent urinary infection in children after antireflux ureterovesical reimplantation in primary vesicorenal reflux].
This study is the outcome of the analysis of 200 cases and concentrates solely on successful antireflux operations (i.e. with neither stenosis nor persistent reflux) performed on primary refluxes, 54 children, all of them being females, have retained refractory postoperative urinary infections. Of these cases, 24 cases (12%) have not been cured yet. In these postoperative infections, some factors play probably no part: the magnitude of the preoperative reflux, the existence of pyelonephritic lesions, the type of germ. However the fact of being female, the age (over 6), the duration of the preoperative infection and, above all, the existence of predominantly vesical symptomatology (frequency, voiding pain, and continence problems such as imperiousness, diurnal incontinence, enuresis) are basic factors. This makes it possible to compose the model of the child that will come up with a rebellious postoperative urinary infection. For these children, suppressing the reflux is only part of the treatment. It will have to be curried on by treating the vesical instability by drugs, vesical reeducation and even psychotherapy. On hand of these observations, one may question the classification of refluxes: do all of them really come under the name of "primary" refluxes?
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D011704:Pyelonephritis / Q000150:complications; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014552:Urinary Tract Infections / Q000209:etiology*; D014555:Urination Disorders / Q000209:etiology; D014718:Vesico-Ureteral Reflux / Q000601:surgery*
Infection urinaire persistante chez l'enfant après réimplantation urétéro-vésicale antireflux pour reflux vésico-rénal primitif.