[Treatment of vesicoureteral reflux in patients with neurogenic bladder. Should the ureter be reimplanted in patients treated with augmentation cystoplasty?].
OBJECTIVE
To evaluate the necessity of performing ureteral reimplantation in patients with vesicoureteral reflux secondary to neurogenic bladder.


METHODS
Retrospective review of 19 patients (10 males and 9 females), between 2 and 19 years of age (Mean age 7 years), with neurogenic bladder and vesicoureteral reflux (VUR) treated from May 1990 to July 2000. No one patient had a satisfactory response to the therapy with anticholinergic drugs and clean intermittent catheterization. All 19 patients underwent augmentation cystoplasty (15 using sigmoid colon and 4 ureter). Ten patients, 16 renal units, underwent simultaneous ureteral reimplantation.


RESULTS
All patients improved their bladder capacity and compliance after bladder augmentation. VUR disappeared in 17 patients. Two patients (3 renal units) in the group without ureteral reimplantation remained with a minor degree of reflux.


CONCLUSIONS
Bladder augmentation alone resolves VUR secondary to neurogenic bladder in a high percentage of patients.
Castellan
Miguel
M
Sanatorio de Niños de Rosario, Hospital de Niños V. J. Vilela, Rosario, Argentina. miguel.castellan@excite.com
Damiani
Horacio
H
Fadil Iturralde
José
J
Sanchez Mazzaferri
Fabio
F
Yunes
Jorge
J
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014513:Ureter / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000150:complications*; D013520:Urologic Surgical Procedures / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000628:therapy*