Cohen cross-trigonal ureteral reimplantation: is a one-year postoperative renal ultrasound scan necessary after normal initial postoperative ultrasound findings?
OBJECTIVE
To determine the utility of the 1-year postoperative renal ultrasound scan in children undergoing uncomplicated Cohen cross-trigonal ureteral reimplantation.


METHODS
A retrospective review of 108 patients (233 ureters) who had undergone uncomplicated Cohen cross-trigonal ureteral reimplantation during a 6.5-year period with a postoperative follow-up of 1 year was performed. Renal ultrasound scans were obtained at 1 month and 1 year postoperatively.


RESULTS
Of the 108 patients who had undergone ureteral reimplantation, 26 patients (24%) had mild to moderate hydronephrosis at 1 month postoperatively. Of these 26 patients, 20 had preexisting hydronephrosis and 6 had new hydronephrosis. Of the 20 patients with preoperative hydronephrosis, 19 (95%) had similar hydronephrosis on the 1-month postoperative ultrasound scan and in 1 (5%), the hydronephrosis had resolved. At 1 year, 13 (69%) of the 20 patients with preoperative hydronephrosis had stable hydronephrosis, and it resolved in 6 (31%). In the 6 patients with new-onset hydronephrosis at 1 month postoperatively, the hydronephrosis had resolved by 1 year in 4 patients (67%) and was mild in 2 (33%). Three patients developed transient obstruction requiring stent placement.


CONCLUSIONS
It has been recommended that a renal ultrasound scan be obtained in children 1 year after open ureteral reimplantation to rule out delayed obstruction. Our results suggest this is of low yield in patients with uncomplicated open ureteral reimplantation.
Ellsworth
Pamela I
PI
Brown University/Hasbro Children's Hospital, Providence, Rhode Island, USA. pamelaellsworth@aol.com
Freilich
Drew A
DA
Lahey
Susan
S
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000601:surgery*; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging*; D008297:Male; D011182:Postoperative Care; D012189:Retrospective Studies; D013997:Time Factors; D014463:Ultrasonography; D014513:Ureter / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000601:surgery*