Objective. To evaluate the efficiency of two different techniques of uretera reimplantation in case of vesicoureteral reflux after transurethral incision of duplex system ureteroceles in children.
Materials and methods. This prospective study included 72 pediatric patients aged 5 months to 14 years (median
22.2 months). The main group consisted of 33 patients who had undergone intravesical reimplantations of duplex ureter the ureterocele excised completely. The control group included 39 children who had undergone extravesical reimplantations of duplex ureter of which 7 patients had undergone simultaneous wide endoscopic incisions of ureterocele, in 6 cases open marsupializations of ureterocele had been performed.
Results. All the patients showed decreased hydronephrosis and megaureter. Recurrent reflux after the surgery was registered in one patient of the main group (3.0%) and in 8 children (20.5%) in the control group (p = 0.033). There were no reoperations in the main group but 8 cases of reoperations in the control group (p = 0.006). The groups did not differ significantly in the terms of urinary tract infection (9% and 23%) or voiding dysfunction (21% and 12%, respectively).
Conclusions. For patients with duplex system ureterocele transvesical ureteral reimplantations with ureterocele removal showed significantly higher rate of the vesicoureteral reflux resolution than extravesical ureteral reimplantations with the ureterocele preservation, transurethral incision or marsupialization.Ключевые слова:
Автор(ы): V. I. Dubrov