title: Endoscopic correction of vesicoureteral reflux in children with a solitary kidney: the risk of obstruction.
abstract: OBJECTIVE
  We aimed to review patients with a solitary kidney and ipsilateral vesicoureteral reflux (VUR) who underwent endoscopic correction of VUR (ECVUR) and to evaluate the prevalence of obstruction in this group of patients.
  
  
  METHODS
  We retrospectively reviewed the files of all patients who underwent ECVUR at our center between January 2000 and June 2011. Only patients with a solitary kidney and ipsilateral VUR were included.
  
  
  RESULTS
  Thirteen patients met our criteria. Two patients (15.38%) developed obstruction post-ECVUR. Both patients developed anuria in the first 24 h after surgery and required intervention. Two patients (15.38%) had increasing hydroureteronephrosis that was discovered on follow-up ultrasound, with no symptoms or signs of obstruction. Both were managed conservatively.
  
  
  CONCLUSIONS
  Our results showed a higher percentage of obstruction post-ECVUR in patients with a solitary kidney (15.38%), who required immediate intervention. Thus, we recommend giving clear instructions to parents of patients with VUR and a solitary kidney post-ECVUR before discharge from the hospital regarding decreased urine output and loin pain. We recommend a follow-up ultrasound to rule out obstruction and detect new-onset hydronephrosis.
authors.affiliation: Urology Division, Department of Surgery, College of Medicine and King Khalid University Hospital, King Saud University, P.O Box 2925, Riyadh 11461, Saudi Arabia. Electronic address: halenezi@hotmail.com.
authors.forename: Husain
authors.initials: H
authors.lastname: Alenezi
authors.forename: Hamdan
authors.initials: H
authors.lastname: Alhazmi
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Trbay
authors.forename: Khalid Fouda
authors.initials: KF
authors.lastname: Neel
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D007668:Kidney / Q000473:pathology; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology / Q000601:surgery*
keywords: Dextranomer/hyaluronic acid copolymer; Dx/HA; ECVUR; HDN; HIT; MMC; Obstruction; Solitary kidney; VCUG; VUR; Vesicoureteral reflux; dextranomer/hyaluronic acid copolymer; endoscopic correction of VUR; hydrodistension-implantation technique; hydronephrosis; myelomeningocele; vesicoureteral reflux; voiding cystourethrogram