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Implications of paraureteral diverticulum for the management of vesicoureteral reflux

Authors
 Young Jae Im  ;  Yong Seung Lee  ;  Sang Woon Kim  ;  Sang Won Han 
Citation
 INTERNATIONAL JOURNAL OF UROLOGY, Vol.22(9) : 850-853, 2015 
Journal Title
 INTERNATIONAL JOURNAL OF UROLOGY 
ISSN
 0919-8172 
Issue Date
2015
MeSH
Child ; Child, Preschool ; Contrast Media ; Diverticulum/complications* ; Diverticulum/diagnostic imaging ; Female ; Fever/etiology ; Humans ; Infant ; Infant, Newborn ; Male ; Radiography ; Recurrence ; Retrospective Studies ; Ureteral Diseases/complications* ; Ureteral Diseases/diagnostic imaging ; Urinary Tract Infections/etiology* ; Vesico-Ureteral Reflux/complications* ; Vesico-Ureteral Reflux/diagnostic imaging ; Vesico-Ureteral Reflux/therapy*
Keywords
bladder ; diverticulum ; ureter ; urinary tract infection ; vesicoureteral reflux
Abstract
OBJECTIVES: To investigate the clinical importance of paraureteral diverticulum in the management of vesicoureteral reflux by analyzing the relationship between paraureteral diverticulum and recurrent urinary tract infections. METHODS: We retrospectively reviewed 131 children diagnosed with vesicoureteral reflux. We diagnosed vesicoureteral reflux and paraureteral diverticulum by initial voiding cystourethrography and defined "delayed ureteral drainage" as the presence of contrast media in the upper urinary tract on delayed films after voiding. We analyzed the relationships between paraureteral diverticulum, delayed ureteral drainage and recurrent urinary tract infections. RESULTS: The mean age at diagnosis of vesicoureteral reflux was 20.7 months. Of the 202 refluxing ureters, 55 (27.2%) had a paraureteral diverticulum. Of the 55 ureters with paraureteral diverticulum, 51 (92.7%) showed delayed ureteral drainage of refluxing contrast, which was significantly higher than the percentage of delayed ureteral drainage in ureters without paraureteral diverticulum (P < 0.001). On multivariate analysis of the effect of reflux grade or paraureteral diverticulum on delayed ureteral drainage of refluxing contrast, the odds ratio of paraureteral diverticulum was 11.47 (P < 0.001). In addition, the risk of recurrent urinary tract infections increased in ureters with paraureteral diverticulum (P = 0.020). CONCLUSIONS: In patients with vesicoureteral reflux and paraureteral diverticulum, the risk of recurrent febrile urinary tract infections seems to increase. Therefore, more progressive surveillance and treatment protocols should be considered in these patients.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/iju.12828/abstract
DOI
10.1111/iju.12828
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Woon(김상운) ORCID logo https://orcid.org/0000-0002-5790-1948
Lee, Yong Seung(이용승) ORCID logo https://orcid.org/0000-0003-3778-9888
Im, Young Jae(임영재)
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/156767
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