title: Prolonged urinary retention can and does occur after any type of ureteral reimplantantion.
abstract: OBJECTIVE
  Transient urinary retention has been recognized as a complication of bilateral ureteroneocystostomy (UNC), when performed extravesically. The objective of this study was to review a collective surgeons' experiences of unilateral extra- and unilateral and/or bilateral intra-vesical ureteral reimplanation, where urinary retention greater than 6 weeks, or what we have termed, "prolonged urinary retention" (PUR), occurred.
  
  
  METHODS
  We retrospectively reviewed charts to identify PUR after any open or robotic reimplant, other than bilateral extravesical, between 1998 and 2015 as reported by five surgeons.
  
  
  RESULTS
  During the review period, ten cases were documented where PUR was encountered. Bilateral Cohen reimplants (5), unilateral extravesical open reimplant with ureteral tapering (3), unilateral Cohen reimplant (1) and unilateral extravesical robotic reimplant with tapering (1) were associated with PUR. Younger males predominated (70%). The mean age at operation of the patients was 3.1 years. Eventually 7/10 patients were able to void normally, with periods ranging from 6 weeks to 8 years. The remaining three patients are still unable to void more than 5 years after UNC. A majority of the samples (6/10) were suspected to have bowel and bladder dysfunction (BBD), but neurologically all were normal.
  
  
  CONCLUSIONS
  PUR can occur as a potential complication following any type of UNC and is associated with the risk of significant morbidity, including permanent urinary retention. Patients and caregivers should be counseled accordingly.
authors.affiliation: Hospital for Sick Children, Toronto, Canada. martin.koyle@sickkids.ca.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Koyle
authors.affiliation: Hospital for Sick Children, Toronto, Canada.
authors.forename: Hissan
authors.initials: H
authors.lastname: Butt
authors.affiliation: Hospital for Sick Children, Toronto, Canada.
authors.forename: Armando
authors.initials: A
authors.lastname: Lorenzo
authors.affiliation: University of Vermont, Burlington, USA.
authors.forename: Gerald C
authors.initials: GC
authors.lastname: Mingin
authors.affiliation: Massachusetts General Hospital, Boston, USA.
authors.forename: Jack S
authors.initials: JS
authors.lastname: Elder
authors.affiliation: Childrens Hospital at Westmead, Sydney, Australia.
authors.forename: Grahame H H
authors.initials: GHH
authors.lastname: Smith
mesh_terms: D001905:Botulinum Toxins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D004106:Dilatation; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*; D012092:Replantation / Q000009:adverse effects*; D012189:Retrospective Studies; D014513:Ureter / Q000601:surgery*; D016055:Urinary Retention / Q000209:etiology* / Q000628:therapy*; D014718:Vesico-Ureteral Reflux / Q000601:surgery*
chemical_list: D001905:Botulinum Toxins
keywords: Megaureter; Ureteral reimplant; Urinary retention; Vesico-ureteral reflux