We investigated the association, treatment options and outcomes of patients with ureteropelvic junction obstruction and concomitant vesicoureteral reflux.
We analyzed 6,790 consecutive pediatric urology records at our university.
Treatment options included observation, and primary pyeloplasty, ureteroneocystostomy and nephroureterectomy.
Hydronephrosis, reflux and obstruction were judged as resolved, improved, unchanged or worse.
A total of 1,140 patients had vesicoureteral reflux, 224 had ureteropelvic junction obstruction and 41 had both conditions (39 ipsilateral and 6 contralateral kidneys).
There was no increased risk of obstruction in patients with reflux when all grades of reflux were grouped (odds ratio 1.26, confidence interval 0.91 to 1.71).
In contrast, subgroup analysis of patients with high grade reflux demonstrated a 5-fold increased risk of obstruction (odds ratio 5.0, confidence interval 2.4 to 10.8).
Observation of 6 kidneys led to resolution of reflux in 3 (50%), resolution of obstruction in 3 (50%) and resolution or improvement of hydronephrosis in 4 (67%). Primary pyeloplasty was done on 29 kidneys with 10 (35%) requiring subsequent ureteroneocystostomy.
At latest followup hydronephrosis resolved or improved in 24 patients (83%), vesicoureteral reflux resolved or improved in 19 (66%) and ureteropelvic junction obstruction resolved in all. (...)
Mots-clés Pascal : Reflux vésicourétéral, Association morbide, Obstruction, Voie urinaire, Jonction urétéropyélique, Incidence, Stratégie, Traitement, Evolution, Article synthèse, Enfant, Homme, Appareil urinaire pathologie, Voie urinaire pathologie, Vessie pathologie, Uretère pathologie, Chirurgie
Mots-clés Pascal anglais : Vesicoureteral reflux, Concomitant disease, Obstruction, Urinary tract, Pelviureteric junction, Incidence, Strategy, Treatment, Evolution, Review, Child, Human, Urinary system disease, Urinary tract disease, Bladder disease, Ureteral disease, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0177679
Code Inist : 002B14C02. Création : 21/05/1997.