Contralateral vesicoureteral reflux after simple and tapered unilateral ureteroneocystostomy revisited.
OBJECTIVE
We reviewed our experience with contralateral vesicoureteral reflux following unilateral ureteroneocystostomy.


METHODS
We retrospectively identified 88 children who underwent unilateral ureteroneocystostomy from 1986 through 1995, including standard repair in 69 and tapered repair in 19. Cystoscopy was performed in all cases immediately before repair.


RESULTS
Grades IV to V vesicoureteral reflux was identified preoperatively in 34% of the patients, including 13 (19%) and 14 (74%) who underwent standard and tapered repair, respectively. Renal duplication was noted in 24% of the cases, including 18 standard (26%) and 3 tapered (16%) repairs. An abnormal contralateral nonrefluxing ureteral orifice was present in 8 of the 53 standard (15%) and 3 of the 14 (21%) tapered cases. Ipsilateral reflux was corrected in all children undergoing standard repair but it persisted in 4 (21%) in the tapered repair group. Postoperatively contralateral vesicoureteral reflux developed in 1 child (1.4%) in the standard and 1 (5.3%) in the tapered repair group.


CONCLUSIONS
Contralateral vesicoureteral reflux is rare and does not appear to be influenced by preoperative reflux grade, a duplicated system or the endoscopic appearance of the ureteral orifice.
McCool
A C
AC
Division of Urology, University of Alabama at Birmingham, Children's Hospital 35233, USA.
Pérez
L M
LM
Joseph
D B
DB
D002648:Child; D003559:Cystostomy; D006801:Humans; D012189:Retrospective Studies; D014519:Ureterostomy; D014718:Vesico-Ureteral Reflux / Q000517:prevention & control / Q000601:surgery*