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J Pediatr Urol. 2013 Feb;9(1):92-8. doi: 10.1016/j.jpurol.2011.12.009. Epub 2012 Jan 18.

Long-term incidence of urinary tract infection after ureteral reimplantation for primary vesicoureteral reflux.

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  • 1Department of Urology, Hunnewell 390, Children's Hospital Boston, 300 Longwood Ave., Boston, MA 02115, USA. caleb.nelson@childrens.harvard.edu

Abstract

OBJECTIVE:

To determine the incidence of urinary tract infection (UTI) after ureteral reimplantation (UR) for primary vesicoureteral reflux (VUR).

MATERIALS AND METHODS:

In this retrospective review, the pyelonephritis-free survival of patients with primary VUR who underwent open UR from January 1990 to December 2002 was assessed using a Cox proportional hazards analysis.

RESULTS:

1076 patients underwent open UR for primary VUR. 73.0% were female; median age was 4.7 years. 80.1% presented with UTI. Clinical success rate for non-tapered UR was 96.5%. Median follow-up was 2.9 years. 21.8% had at least one postoperative UTI. 6.5% had postoperative pyelonephritis (POP) at a median of 21 months postoperatively. On multivariate survival analysis female gender (OR 9.97, 95% CI 3.07-32.34), preoperative VUR grade ≥ 3 (2.14, 1.25-3.69), breakthrough preoperative UTI (2.00, 1.22-3.25), and preoperative renal scarring (1.86, 1.15-2.99) were associated with POP.

CONCLUSION:

POP is rare on long-term follow-up, suggesting that UR is effective in reducing pyelonephritis in this population.

Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

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PMID:
22261484
[PubMed - indexed for MEDLINE]
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