title: Durability of antireflux effect of ureteral reimplantation for primary vesicoureteral reflux: findings on long-term cystography.
abstract: OBJECTIVE
  To evaluate the long-term durability of successful ureteral reimplantation (UR) for vesicoureteral reflux (VUR) through a review of late cystography (LC) findings.
  
  
  METHODS
  We performed a retrospective chart review of all children with primary VUR who underwent successful open UR (grade 0 VUR into the reimplanted ureter[s] on initial cystogram) at our institution from January 1990 to December 2002. We identified successful UR patients who underwent LC ≥ 1 year after UR and reviewed the results for the presence of recurrent VUR into the reimplanted ureter(s).
  
  
  RESULTS
  Seven-hundred ninety-four patients underwent successful open UR for primary VUR, of whom 60 (7.6%) had a subsequent LC. Preoperative VUR grade was ≤ II in 20 (34.5%) and ≥ III in 38 (65.5%). Median age at UR was 3.5 years (IQR 1.3-6.2 years); 51 (85%) were female. UR was intravesical in 45 (75%) and bilateral in 19 (32%). LC was performed at a median of 38.7 months after UR (IQR 19.6-66.1 months). Indication for LC was febrile urinary tract infection (UTI) in 16 (27%), nonfebrile UTIs in 15 (25%), follow-up of contralateral VUR in 16 (27%), and other clinical indications in 13 (21%). The recurrence rate was 0%; of the 79 reimplanted ureters, 100% (95% CI 95.4-100) had no VUR (grade 0).
  
  
  CONCLUSIONS
  Among children who underwent successful open UR for primary VUR, there was no VUR recurrence on extended follow-up. This suggests that the late durability of open antireflux surgery is excellent.
authors.affiliation: Department of Urology, Children's Hospital Boston, Boston, MA 02115, USA.
authors.forename: Katherine C
authors.initials: KC
authors.lastname: Hubert
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Kokorowski
authors.forename: Lin
authors.initials: L
authors.lastname: Huang
authors.forename: Michaella M
authors.initials: MM
authors.lastname: Prasad
authors.forename: Ilina
authors.initials: I
authors.lastname: Rosoklija
authors.forename: Alan B
authors.initials: AB
authors.lastname: Retik
authors.forename: Caleb P
authors.initials: CP
authors.lastname: Nelson
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012008:Recurrence; D012092:Replantation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000000981:diagnostic imaging / Q000601:surgery*; D014552:Urinary Tract Infections / Q000209:etiology; D013520:Urologic Surgical Procedures / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*