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Complications After Common Sheath Reimplantation in Pediatric Patients With Complicated Duplex System

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Author(s)
하지용
Alternative Author(s)
Ha, Ji Yong
Publication Year
2015
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 post-
operative 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 ¼ .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 incon-
tinence 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. UROLOGY 85: 457e462, 2015. 2015 Elsevier Inc.
Department
Dept. of Urology (비뇨의학)
Publisher
School of Medicine
Citation
urology, Vol.85(2) : 457-462, 2015
Type
Article
ISSN
0090-4295
DOI
10.1016/j.urology.2014.10.014
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34790
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