title: Long-term incidence of urinary tract infection after ureteral reimplantation for primary vesicoureteral reflux.
abstract: OBJECTIVE
  To determine the incidence of urinary tract infection (UTI) after ureteral reimplantation (UR) for primary vesicoureteral reflux (VUR).
  
  
  METHODS
  In this retrospective review, the pyelonephritis-free survival of patients with primary VUR who underwent open UR from January 1990 to December 2002 was assessed using a Cox proportional hazards analysis.
  
  
  RESULTS
  1076 patients underwent open UR for primary VUR. 73.0% were female; median age was 4.7 years. 80.1% presented with UTI. Clinical success rate for non-tapered UR was 96.5%. Median follow-up was 2.9 years. 21.8% had at least one postoperative UTI. 6.5% had postoperative pyelonephritis (POP) at a median of 21 months postoperatively. On multivariate survival analysis female gender (OR 9.97, 95% CI 3.07-32.34), preoperative VUR grade ≥ 3 (2.14, 1.25-3.69), breakthrough preoperative UTI (2.00, 1.22-3.25), and preoperative renal scarring (1.86, 1.15-2.99) were associated with POP.
  
  
  CONCLUSIONS
  POP is rare on long-term follow-up, suggesting that UR is effective in reducing pyelonephritis in this population.
authors.affiliation: Department of Urology, Hunnewell 390, Children's Hospital Boston, 300 Longwood Ave., Boston, MA 02115, USA. caleb.nelson@childrens.harvard.edu
authors.forename: Caleb P
authors.initials: CP
authors.lastname: Nelson
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
mesh_terms: D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011704:Pyelonephritis / Q000453:epidemiology; D012092:Replantation / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014513:Ureter / Q000601:surgery*; D014552:Urinary Tract Infections / Q000453:epidemiology*; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology* / Q000601:surgery*