Extravesical verses intravesical ureteral reimplantation in paediatric patients suffering from vesicoureteric reflux.

Abstract

Objective: To compare two different techniques for ureteric reimplantation for management of Vesicoureteric reflux in children. Study Design: Comparative study. Setting: Department of Pediatric surgery at D. G Khan Medical College Dera Ghazi Khan. Period: January 2010 to April 2021. Material & Methods: Seventy four patients with vesicoureteric reflux were included. Extravesical reimplantation technique was performed in 35 children labeled as Group A , while intravesical reimplantation was performed in 39 children labeled as Group B. Parameters compared between two groups were length of the surgical procedure, average duration of hospital stay, postoperative bladder spasms, significant hematuria >72 h, and long-term complications. Results: The mean age at operation was 6.5 years in Group A and 6.35years in Group B. The mean duration of surgery was significantly less in Group A .i.e 104 min with SD 18 min compared to Group B where mean duration was 128 min; SD 15 min. The mean postoperative stay was significantly lower (P value =0.032) at 4.5 (1.5) days in Group A compared to 6.5 (0.5) days in Group B. Postoperative bladder spasms were significantly lower (P = 0.003) at 1/35 in Group A compared to 35/39 in Group B. Postoperative hematuria was significantly lower (P =0.001) in Group A compared to Group B. Conclusion: Extravesical reimplantation technique has lower operative time, less postoperative discomfort and shorter hospital stay compared to intravesical reimplantation. Both techniques are equally effective in treating reflux.