MP55-08 PREVALENCE AND RISK FACTORS OF SYMPTOMATIC URINARY TRACT INFECTION AFTER ENDOSCOPIC INCISION FOR THE TREATMENT OF URETEROCELE IN CHILDREN.

Abstract

You have accessJournal of UrologyPediatrics: Urinary Tract Infection and Vesicoureteral Reflux1 Apr 2016MP55-08 PREVALENCE AND RISK FACTORS OF SYMPTOMATIC URINARY TRACT INFECTION AFTER ENDOSCOPIC INCISION FOR THE TREATMENT OF URETEROCELE IN CHILDREN. Kimihiko Moriya, Michiko Nakamura, Yoko Nishimura, Takeya Kitta, Kanno Yukiko, Hiroki Chiba, Masafumi Kon, and Nobuo Shinohara Kimihiko MoriyaKimihiko Moriya More articles by this author , Michiko NakamuraMichiko Nakamura More articles by this author , Yoko NishimuraYoko Nishimura More articles by this author , Takeya KittaTakeya Kitta More articles by this author , Kanno YukikoKanno Yukiko More articles by this author , Hiroki ChibaHiroki Chiba More articles by this author , Masafumi KonMasafumi Kon More articles by this author , and Nobuo ShinoharaNobuo Shinohara More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.599AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Endoscopic incision (EI) is widely accepted as a minimally invasive management for ureterocele (UC). While incidence of inherent or de novo vesicoureteral reflux (VUR) was reported so far, risk of urinary tract infection (UTI) after EI has not been well discussed. In the present study, impact of EI for UC was evaluated focusing on prevalence and risk factors of symptomatic UTI after EI. METHODS We performed retrospective chart review of children with UC between September 1994 and April 2015. Among them, patients who were observed conservatively without additional surgical management after EI were included in this study. Type of UC was divided into intravesical (I-UC) and ectopic (E-UC) ones. Prevalence and risk factors of symptomatic UTI, which was defined recurrent cystitis or febrile UTI, after EI were evaluated. Statistical analysis was performed using Kaplan-Maier Curve with the generalized Wilcoxon test for evaluation of the prevalence and risk factors for symptomatic UTI. RESULTS Among 38 children with UC during the study period, 36 children (20 girls and 16 boys) were included. The reason of exclusion in 2 boys with E-UC were that open ureterocystoneostomy was indicated just after EI due to ectopic opening of ureteral orifice into urethra in 1 and due to their guardian's preference in 1. Surgical indications for EI were symptomatic UTI in 23, hydronephrosis in 8, macrohematuria in 3 and others in 2. I-UC and E-UC was identified in 15 and 21, respectively. Median age at EI was 8.9 months (range; 1.6 to 190). Ten children had symptomatic UTI (febrile UTI in 8 and recurrent cystitis in 2) during median follow of 72.9 months (7.1 to 219). Initial symptomatic UTI in each child occurred at less than 25 months after EI (0.5 to 24.9). Symptomatic UTI was less common in boys (p<0.01) or children with I-UC (p <0.05). Symptomatic UTI free rate at 25 months after EI (%) was 91.7/45.1 in boys/girls, 81.8/55.4 in I-UC/E-UC, or 86.7/40.5 in boys or I-UC/girls with E-UC. Symptomatic UTI as presenting symptom (p =0.148), bilateral/unilateral UC (p =0.236), single/duplex system in UC unit (p =0.068), age at EI (p =0.393), or inherent or de novo VUR after EI (p =0.233) did not affect the prevalence of symptomatic UTI. CONCLUSIONS Symptomatic UTI occurred within 25 months after EI. Boys and children with I-UC were at a lower risk for symptomatic UTI after EI. Our data suggests that conservative management after EI would be a safe option in terms of symptomatic UTI for the management of UC especially in boys or in children with I-UC even though VUR was identified after EI. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e738 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Kimihiko Moriya More articles by this author Michiko Nakamura More articles by this author Yoko Nishimura More articles by this author Takeya Kitta More articles by this author Kanno Yukiko More articles by this author Hiroki Chiba More articles by this author Masafumi Kon More articles by this author Nobuo Shinohara More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...