Reflux in cystoplasties.
Vesicoureteral reflux is a commonly encountered condition in pediatric urology. The treatment of vesicoureteral reflux is debated in all patients. Much controversy exists regarding the need to reimplant refluxing ureters at the time of bladder augmentation, particularly in those patients with neuropathic bladders. In patients with neuropathic bladders, reflux may be the result of elevated detrusor pressure, recurrent/persistent urinary tract infections and/or a neuropathic dysfunction at the ureterovesical junction and the trigone. Treatment of VUR in patients undergoing bladder augmentation varies and includes routinely reimplanting all refluxing ureters, selectively reimplanting ureters with high-grade reflux or avoiding anti-reflux surgery in all patients regardless of the grade of reflux. We review the literature and our experience with the treatment of vesicoureteral reflux in patients that have undergone augmentation cystoplasty.
Misseri
Rosalia
R
Pediatric Urology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis 46202, USA. rmisseri@iupui.ed
Rosenbaum
David H
DH
Rink
Richard C
RC
D002648:Child; D006801:Humans; D012189:Retrospective Studies; D001750:Urinary Bladder, Neurogenic / Q000150:complications* / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000601:surgery*