title: Laparoscopic extravesical reimplantation for postpubertal vesicoureteral reflux.
abstract: OBJECTIVE
  Postpubertal vesicoureteral reflux is a rare occurrence. In the adolescent group, its repair can be a challenging open procedure. We present our preliminary experience with laparoscopic extravesical ureteral reimplantation for postpubertal vesicoureteral reflux.
  
  
  METHODS
  Six female patients with a mean age of 18.7 years presented with recurrent urinary tract infection secondary to vesicoureteral reflux. The indications for treatment were febrile urinary tract infection, recurrent pyelonephritis, renal scarring, and breakthrough urinary tract infection. The reflux was unilateral in all patients at the time of treatment, but one patient had previously experienced bilateral reflux and had persistent left-sided reflux following subureteral injection of Durasphere. This patient underwent bilateral laparoscopic extravesical ureteral reimplantation.
  
  
  RESULTS
  The mean operative times for the unilateral and bilateral procedures were 1.75 hours and 3.75 hours, respectively. The average length of stay in the hospital was 36 hours; five patients went home in <24 hours. The mean time to resumption of full activity was 8 days. All six patients had resolution of vesicoureteral reflux, as shown by radiographic studies, with a mean follow-up of 11.4 months.
  
  
  CONCLUSIONS
  Laparoscopic extravesical ureteral reimplantation for postpubertal vesicoureteral reflux has excellent outcomes with minimal postoperative morbidity. Long-term radiographic follow-up is needed.
authors.affiliation: Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: Tung
authors.initials: T
authors.lastname: Shu
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Cisek
authors.forename: Robert G
authors.initials: RG
authors.lastname: Moore
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D014718:Vesico-Ureteral Reflux / Q000601:surgery*