Complications after common sheath reimplantation in pediatric patients with complicated duplex system

Yong Seung Lee, Young Jae Im, Sang Hee Shin, Rosito T. Bascuna, Ji Yong Ha, Sang Won Han

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective To report our experience of common sheath reimplantation (CSR) for ectopic ureterocele (EU) combined with ureteral duplication, describing success rates and postoperative complications, along with risk factors for developing postoperative incontinence. Methods When the upper tract approach is not indicated in patients with EU, a bladder-level approach, involving either CSR or total reconstruction, is the remaining option. However, concerns exist about the high morbidity of bladder-level approaches. We retrospectively examined the postoperative results of 39 patients who underwent CSR between January 2001 and December 2012. Risk factors for the development of postoperative incontinence and decreases in differential renal function (DRF) were additionally analyzed. Results The median age at operation was 16.5 months. After CSR, upper urinary tract dilatation decreased in 36 patients (92.3%). During a median follow-up of 75.9 months, an additional operation was required in 7 patients (17.9%). Postoperative incontinence developed in 3 patients (7.7%). Median preoperative DRF was significantly lower in the postoperative incontinence group (P =.004). DRF decreased postoperatively in 5 of 36 patients (13.9%). No preoperative factors were related to the decrease in DRF. No patient developed hypertension or proteinuria. Conclusion CSR decompressed the upper urinary tract effectively in our EU patients. Postoperative incontinence does not seem to be related to operation factors, but with preoperative DRF. When the upper tract approach is not indicated, CSR is a reasonable alternative. Total reconstruction is unnecessary as the remnant upper pole kidney after CSR does not lead to complications.

Original languageEnglish
Pages (from-to)457-462
Number of pages6
JournalUrology
Volume85
Issue number2
DOIs
Publication statusPublished - 2015 Feb 1

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Replantation
Pediatrics
Ureterocele
Kidney
Urinary Tract
Urinary Bladder
Proteinuria
Dilatation
Hypertension
Morbidity

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Lee, Yong Seung ; Im, Young Jae ; Shin, Sang Hee ; Bascuna, Rosito T. ; Ha, Ji Yong ; Han, Sang Won. / Complications after common sheath reimplantation in pediatric patients with complicated duplex system. In: Urology. 2015 ; Vol. 85, No. 2. pp. 457-462.
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title = "Complications after common sheath reimplantation in pediatric patients with complicated duplex system",
abstract = "Objective To report our experience of common sheath reimplantation (CSR) for ectopic ureterocele (EU) combined with ureteral duplication, describing success rates and postoperative complications, along with risk factors for developing postoperative incontinence. Methods When the upper tract approach is not indicated in patients with EU, a bladder-level approach, involving either CSR or total reconstruction, is the remaining option. However, concerns exist about the high morbidity of bladder-level approaches. We retrospectively examined the postoperative results of 39 patients who underwent CSR between January 2001 and December 2012. Risk factors for the development of postoperative incontinence and decreases in differential renal function (DRF) were additionally analyzed. Results The median age at operation was 16.5 months. After CSR, upper urinary tract dilatation decreased in 36 patients (92.3{\%}). During a median follow-up of 75.9 months, an additional operation was required in 7 patients (17.9{\%}). Postoperative incontinence developed in 3 patients (7.7{\%}). Median preoperative DRF was significantly lower in the postoperative incontinence group (P =.004). DRF decreased postoperatively in 5 of 36 patients (13.9{\%}). No preoperative factors were related to the decrease in DRF. No patient developed hypertension or proteinuria. Conclusion CSR decompressed the upper urinary tract effectively in our EU patients. Postoperative incontinence does not seem to be related to operation factors, but with preoperative DRF. When the upper tract approach is not indicated, CSR is a reasonable alternative. Total reconstruction is unnecessary as the remnant upper pole kidney after CSR does not lead to complications.",
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Complications after common sheath reimplantation in pediatric patients with complicated duplex system. / Lee, Yong Seung; Im, Young Jae; Shin, Sang Hee; Bascuna, Rosito T.; Ha, Ji Yong; Han, Sang Won.

In: Urology, Vol. 85, No. 2, 01.02.2015, p. 457-462.

Research output: Contribution to journalArticle

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T1 - Complications after common sheath reimplantation in pediatric patients with complicated duplex system

AU - Lee, Yong Seung

AU - Im, Young Jae

AU - Shin, Sang Hee

AU - Bascuna, Rosito T.

AU - Ha, Ji Yong

AU - Han, Sang Won

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N2 - Objective To report our experience of common sheath reimplantation (CSR) for ectopic ureterocele (EU) combined with ureteral duplication, describing success rates and postoperative complications, along with risk factors for developing postoperative incontinence. Methods When the upper tract approach is not indicated in patients with EU, a bladder-level approach, involving either CSR or total reconstruction, is the remaining option. However, concerns exist about the high morbidity of bladder-level approaches. We retrospectively examined the postoperative results of 39 patients who underwent CSR between January 2001 and December 2012. Risk factors for the development of postoperative incontinence and decreases in differential renal function (DRF) were additionally analyzed. Results The median age at operation was 16.5 months. After CSR, upper urinary tract dilatation decreased in 36 patients (92.3%). During a median follow-up of 75.9 months, an additional operation was required in 7 patients (17.9%). Postoperative incontinence developed in 3 patients (7.7%). Median preoperative DRF was significantly lower in the postoperative incontinence group (P =.004). DRF decreased postoperatively in 5 of 36 patients (13.9%). No preoperative factors were related to the decrease in DRF. No patient developed hypertension or proteinuria. Conclusion CSR decompressed the upper urinary tract effectively in our EU patients. Postoperative incontinence does not seem to be related to operation factors, but with preoperative DRF. When the upper tract approach is not indicated, CSR is a reasonable alternative. Total reconstruction is unnecessary as the remnant upper pole kidney after CSR does not lead to complications.

AB - Objective To report our experience of common sheath reimplantation (CSR) for ectopic ureterocele (EU) combined with ureteral duplication, describing success rates and postoperative complications, along with risk factors for developing postoperative incontinence. Methods When the upper tract approach is not indicated in patients with EU, a bladder-level approach, involving either CSR or total reconstruction, is the remaining option. However, concerns exist about the high morbidity of bladder-level approaches. We retrospectively examined the postoperative results of 39 patients who underwent CSR between January 2001 and December 2012. Risk factors for the development of postoperative incontinence and decreases in differential renal function (DRF) were additionally analyzed. Results The median age at operation was 16.5 months. After CSR, upper urinary tract dilatation decreased in 36 patients (92.3%). During a median follow-up of 75.9 months, an additional operation was required in 7 patients (17.9%). Postoperative incontinence developed in 3 patients (7.7%). Median preoperative DRF was significantly lower in the postoperative incontinence group (P =.004). DRF decreased postoperatively in 5 of 36 patients (13.9%). No preoperative factors were related to the decrease in DRF. No patient developed hypertension or proteinuria. Conclusion CSR decompressed the upper urinary tract effectively in our EU patients. Postoperative incontinence does not seem to be related to operation factors, but with preoperative DRF. When the upper tract approach is not indicated, CSR is a reasonable alternative. Total reconstruction is unnecessary as the remnant upper pole kidney after CSR does not lead to complications.

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