The role of refluxing distal ureteral stumps after nephrectomy.
OBJECTIVE
Classically, the refluxing distal ureteral stump has been removed during the nephrectomy by the means of an incision on the flank and lower abdominal wall. There are little data in the literature about the natural history of these stumps. In the current work the authors evaluated possible complications affecting the ureteral stump after total or partial nephrectomy for vesicoureteral reflux.


METHODS
Between June 1974 and May 1991, our institution performed 25 nephrectomies followed by partial ureterectomy to correct vesicoureteral reflux into a nonfunctional kidney. The authors performed, respectively, 16 total and 9 partial nephrectomies. The reflux to operated units was graded according to the International Grading System as grade 1 (n = 1), grade 2 (n = 4), grade 3 (n = 9), grade 4 (n = 8), and grade 5 (n = 1).


RESULTS
Ureteral stump removal was performed in 3 patients (13%). No correlation between the need for ureteral stump removal and age, gender, grade of preoperative reflux, associated contralateral reflux, and ureteral histology, became apparent.


CONCLUSIONS
The remainder of the ureteral stump, after a total or partial nephrectomy to correct vesicoureteral reflux, presents a low rate of complications even in the presence of a high grade of reflux.
Barroso
Ubirajara
U
Instituto de Urologia e Nefrologia, São José do Rio Preto, São Paulo, Brazil.
Calado
Adriano Almeida
AA
Filho
Miguel Zerati
MZ
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014513:Ureter / Q000503:physiopathology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000503:physiopathology / Q000601:surgery*