title: Critical Analysis of a Series of Early Inguinal Ureterostomies: Are They Useful and How Well Are They Tolerated?
abstract: BACKGROUND
  The study aimed to evaluate the advantages of temporary inguinal ureterostomy in the management of neonates with uropathies and early or recurrent pyelonephritis.
  
  
  METHODS
  We performed a retrospective analysis of all patients who underwent ureterostomies between 1989 and 2012, with specific regards to indications and outcomes. We also performed a survey of parents to evaluate their acceptance of diversion.
  
  
  RESULTS
  We included 18 patients (12 primary high-grade vesicoureteral reflux [VUR] and 6 primary obstructive megaureters [MUs]). Indications were recurrent febrile urinary tract infections (UTIs) despite antibiotic prophylaxis, doubtful function of the overlying kidney for the oldest cases, when renal function was only assessed by intravenous urography, or both. Cutaneous diversion was performed between the ages of 2 weeks to 5 months (median: 1.8 months). Renal function was assessed prior to undiversion to choose between reimplantation and nephrectomy. The incidence of febrile UTIs significantly decreased during the period of diversion. Urinary diversion was judged socially acceptable by parents. Ureterostomy did not modify the overlying kidney function.
  
  
  CONCLUSIONS
  Temporary inguinal ureterostomy does not enable better evaluation of renal function by suppressing the pressure of an obstacle or refluxing urines. Its remaining indication seems to be the prevention of recurrent UTIs in neonates and infants with VUR or MU, pending reimplantation.
authors.affiliation: Department of Urology, Royal Children's Hospital, Parkville, Australia.
authors.forename: Aurore
authors.initials: A
authors.lastname: Bouty
authors.forename: Yan
authors.initials: Y
authors.lastname: Lefevre
authors.forename: Luke
authors.initials: L
authors.lastname: Harper
authors.forename: Antoine
authors.initials: A
authors.lastname: Tran
authors.forename: Pierre
authors.initials: P
authors.lastname: Vergnes
authors.forename: Eric
authors.initials: E
authors.lastname: Dobremez
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007668:Kidney / Q000601:surgery; D007678:Kidney Glomerulus / Q000473:pathology; D008297:Male; D009392:Nephrectomy; D017060:Patient Satisfaction; D011704:Pyelonephritis / Q000601:surgery; D012008:Recurrence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000601:surgery*; D014519:Ureterostomy / Q000379:methods*; D014547:Urinary Diversion; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000473:pathology / Q000517:prevention & control; D014718:Vesico-Ureteral Reflux / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents