476 OUTCOME OF MINIMALLY INVASIVE SURGICAL APPROACH TO MANAGE HIGH-GRADE VESICOURETERIC REFLUX IN PATIENTS WITH NON-COMPLIANT BLADDER POST AUGMENTATION CYSTOPLASTY

Abstract

You have accessJournal of UrologyPediatrics: Neuropathic Bladder/Reconstruction1 Apr 2013476 OUTCOME OF MINIMALLY INVASIVE SURGICAL APPROACH TO MANAGE HIGH-GRADE VESICOURETERIC REFLUX IN PATIENTS WITH NON-COMPLIANT BLADDER POST AUGMENTATION CYSTOPLASTY Ossamah Alsowayan, Alaa Barham, Mansour Alnazari, Mahmoud Alsakharni, Tamer Ewida, Hamdan Alhazmi, and Khalid Fouda Ossamah AlsowayanOssamah Alsowayan Riyadh, Saudi Arabia More articles by this author , Alaa BarhamAlaa Barham Riyadh, Saudi Arabia More articles by this author , Mansour AlnazariMansour Alnazari Riyadh, Saudi Arabia More articles by this author , Mahmoud AlsakharniMahmoud Alsakharni Riyadh, Saudi Arabia More articles by this author , Tamer EwidaTamer Ewida Riyadh, Saudi Arabia More articles by this author , Hamdan AlhazmiHamdan Alhazmi Riyadh, Saudi Arabia More articles by this author , and Khalid FoudaKhalid Fouda Riyadh, Saudi Arabia More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1868AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To assess the outcome of minimally invasive surgical approach to manage high-grade vesicoureteric reflux (VUR) in patients with non-compliant bladder post augmentation cystoplasty. METHODS Between 2001 and 2011, 24 (13 male and 11 female, mean age 7.62 years) patients with non-compliant bladder and 44 highly refluxing units (40 bilateral and 4 unilateral, grade 3–5), underwent augmentation cystoplasy with no ureteric reimplantation. Of the 24 patients, 17 underwent augmentation ileocystoplasty and 7 underwent ureterocystoplasy. áOut of the 44 refluxing ureters, 7 were used for ureterocystoplasty, and one was excised. RESULTS Of the 36 remaining refluxing units, 21 (58.3%) showed complete resolution in the first follow up cystogram, and one after one year. 2 patients, with single refluxing unit for each, had redo augmentation cystoplasty because of inadequate capacity and showed complete resolution of reflux post operatively. Of the remaining 12 refluxing units, 10 underwent endoscopic intervention. VUR resolved in 8 refluxing units after the first trial, and in another 2 after the second trial. Parents of patient with the remaining 2 refluxing units preferred to continue with conservative management. CONCLUSIONS Augmentation cystoplasty without ureteric reimplantation, and interval endoscopic management if needed, is an effective and adequate treatment for high pressure, non-compliant bladder as well as high-grade VUR when conservative management fails. In our experience, a resolution rate of 94% of high-grade reflux in combined conservative and minimally invasive approach can be achieved with no need of ureteric reimplantation at time of augmentation cystoplasty. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e196 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ossamah Alsowayan Riyadh, Saudi Arabia More articles by this author Alaa Barham Riyadh, Saudi Arabia More articles by this author Mansour Alnazari Riyadh, Saudi Arabia More articles by this author Mahmoud Alsakharni Riyadh, Saudi Arabia More articles by this author Tamer Ewida Riyadh, Saudi Arabia More articles by this author Hamdan Alhazmi Riyadh, Saudi Arabia More articles by this author Khalid Fouda Riyadh, Saudi Arabia More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...