Trigonoplasty to treat secondary vesicoureteral reflux in neurogenic bladders.
OBJECTIVE
The effectiveness of Gil-Vernet's trigonoplasty, with technical modifications, was studied in treating vesicoureteral reflux (VUR) in neurogenic bladders.


METHODS
Modified Gil-Vernet's trigonoplasty, making the transmural ureters advance over the midline and cross each other in the trigone, was applied in patients with neurogenic bladder dysfunction and VUR, diagnosed by voiding cystourethrogram. Most of the patients were sufficiently followed up by cystourethrogram.


RESULTS
26 patients with neurogenic bladder dysfunction were diagnosed as having 43 refluxing units and underwent modified Gil-Vernet's trigonoplasty. Reflux was grade I in 5 units, grade II in 7, grade III in 5, grade IV in 18, and grade V in 8, with unilateral reflux in 9 patients and bilateral reflux in 17. Surgery was successful in 95.3% of 43 refluxing units. 22 patients were followed 3-6 months after the operation, and the cure rate was 90.9% (no reflux under voiding cystourethrogram). 18 patients were followed up for more than 2 years without recurrence of VUR.


CONCLUSIONS
Modified Gil-Vernet's trigonoplasty might be a useful technique in the management of patients with VUR secondary to neurogenic bladder dysfunction.
Zhao
Jimao
J
Department of Urology, Beijing Friendship Hospital, Capital University of Medicine Sciences, Beijing 100050, PR China. zhaojimao@hotmail.com
Zhang
Yuhai
Y
Lu
Wencheng
W
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D001750:Urinary Bladder, Neurogenic / Q000150:complications*; D013520:Urologic Surgical Procedures / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000601:surgery*