Ureteral reimplantation in infants and children: effect on bladder function.
OBJECTIVE
We investigate whether early ureteral reimplantation in infants damages the urodynamic behavior of the bladder compared to ureteral reimplantation after age 1 year. We also evaluate changes in bladder behavior after ureteral reimplantation.


METHODS
We compared 2 groups of 25 children each who underwent ureteral reimplantation. Group 1 included children younger than 12 months at surgery, and group 2 children were between 1 and 10 years old. All patients had grade III or greater reflux in 1 or 2 ureters, or obstructed megaureters. All patients underwent a complete urodynamic study before and after surgery. We analyzed preoperative and postoperative differences in urodynamic studies in both groups concerning bladder instability, capacity and compliance.


RESULTS
Our analysis of urodynamic data showed that bladder instability was reduced more in group 1 than group 2, although not statistically significant. Parameters for bladder capacity and compliance were comparable for both groups. No statistically significant difference was noted between the urodynamic results in both groups preoperatively and postoperatively.


CONCLUSIONS
No difference in urodynamic parameters could be found between children younger than 12 months compared to those older who underwent ureteral reimplantation. The urodynamic data do not provide any contraindication to ureteral reimplantation performed in early infancy. Moreover, except for a minor reduction in bladder instability, ureteral reimplantation does not alter the urodynamic behavior of the bladder.
de Kort
Laetitia M O
LM
Department of Pediatric Urology, Julius Center for General Practice and Patient-oriented Research, University Children's Hospital, Utrecht, The Netherlands.
Klijn
Aart J
AJ
Uiterwaal
Cuno S P M
CS
de Jong
Tom P V M
TP
D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012092:Replantation; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000503:physiopathology*; D014563:Urodynamics / Q000502:physiology; D014718:Vesico-Ureteral Reflux / Q000601:surgery*