A modified technique to correct primary vesicoureteral reflux in children.
OBJECTIVE
The authors describe the experience of a modified technique to correct primary vesicoureteral reflux in children.


METHODS
Twenty children (28 renal units) with primary vesicoureteral reflux (grade III to grade IV) were treated with this technique. The authors incised the bladder mucosa and muscle along the direction of the ureter using a right-angled probe as a guide. About 2 to 3 cm of extravesical ureter was freed and pulled into the bladder via the incision. The bladder muscle was closed under the ureter, and the mucosa was repaired over the ureter.


RESULTS
One patient had residual reflux. All other patients, who underwent follow-up with sonogram and voiding cystourethrogram from 14 to 42 months after the operation, had neither recurrent reflux nor urinary tract obstruction.


CONCLUSIONS
The advantages of this technique are (1) anastomosis of the ureteral orifice to the urinary bladder is not needed, so that the risk of orifice stenosis is minimized; (2) the ureteral orifice remains unchanged after the procedure, so that ureteroscopic procedures are easier to perform in future if required; and (3) pelvic dissection is not needed as in extravesical detrusorrhaphy. However, this procedure may not be suitable for patients with severe hydroureter.
Chin
T
T
Section of Pediatric Surgery, Veterans General Hospital-Taipei, National Yangming University, Taiwan, Republic of China.
Liu
C
C
Wei
C
C
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013520:Urologic Surgical Procedures / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000601:surgery*