방광근 외봉법 (Detrusorrhaphy)에 의한 방광요관문합술의 치료 성적과 유용성

Abstract

Purpose: Various techniques for ureteral reimplantation have been described for correction of vesicoureteral reflux. We evaluated the results of extravesical ureteral reimplantation using detrusorrhaphy techniques in children. Materials and Methods: From January 1999 to July 2000 we retrospectively reviewed the records of 35 children(53 ureters) who underwent ureteral reimplantation using detrusorrhaphy techniques for correction of primary vesicoureteral reflux. Results: There were 21 male and 14 female patients. The initial reflux grades were I, II, III, IV and V in 4, 8, 13, 20 and 8 ureters, respectively. This surgery was successful initially in 51(96.2%) in 53 ureters, as confirmed by a normal voiding cystourethrogram 6 months postoperatively. Of the 53 ureters vesicoureteral reflux persisted in 2 ureters, contralateral reflux developed in 2 ureters, which was treated conservatively. No ureteral obstruction developed, but urinary tract infection developed in 2 children postoperatively. Urinary retention developed in 2 children with successful recovery after urethral catheter drainage of 7 days. The duration of hospitalization ranged from 2 to 4 days(2.6 days). Conclusions: Regardless of the initial results the detrusorrhaphy technique was successful as other ureteral reimplantation techniques. Also it was simple to perform, reproducible and associated with low morbidity. So far it required minimal hospital stay. These results should encourage the use of this technique when indicated to correct vesicoureteral reflux in children.