Abstract

A 9-year-old girl with grade 4-5 right vesico-ureteric reflux (VUR) into a solitary collecting system was initially treated with endoscopic Deflux injection. Micturition cystourethrogram (MCUG) performed after 6 months showed a grade 1-2 reflux. After 3 years, MCUG repeated due to recurrent urinary tract infection (UTI), showed severe VUR. DMSA renal scan showed a non-functioning right kidney. The patient underwent a right nephrectomy by retroperitoneoscopic approach. A small distal ureteral stump (DUS) was left. One year after surgery, another MCUG was performed due to recurrent UTI showed an active VUR in the ureteral stump (Fig.1). The 5cm long DUS (Fig. 2) was surgically removed. The child is asymptomatic at follow-up of 5 years.

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