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Does hydronephrosis after extravesical ureteral reimplantation deteriorate renal function?

Authors
 Yong Seung Lee  ;  Young Jae Im  ;  Hyun Jin Jung  ;  Yoon Soo Hah  ;  Chang Hee Hong  ;  Sang Won Han 
Citation
 Journal of Urology, Vol.187(2) : 670-675, 2012 
Journal Title
 Journal of Urology 
ISSN
 0022-5347 
Issue Date
2012
MeSH
Child ; Child, Preschool ; Female ; Humans ; Hydronephrosis/complications* ; Infant ; Kidney/physiopathology* ; Kidney Diseases/etiology* ; Male ; Postoperative Complications/etiology* ; Retrospective Studies ; Ureter/surgery* ; Urologic Surgical Procedures/methods ; Vesico-Ureteral Reflux/surgery*
Keywords
ultrasonography ; ureter ; urinary bladder ; vesico-ureteral reflux
Abstract
PURPOSE: We analyzed whether newly developed or aggravated hydronephrosis deteriorates differential renal function after extravesical ureteral reimplantation. MATERIALS AND METHODS: We performed extravesical ureteral reimplantation in 93 patients with unilateral vesicoureteral reflux between January 2006 and December 2009. Excluding 3 patients with other combined disease, a retrospective cohort analysis of 90 consecutive patients was conducted. We performed ultrasonography before and 1 month after extravesical ureteral reimplantation, and dimercapto-succinic acid scan before and 6 months after extravesical ureteral reimplantation. Of the patients 83 underwent final dimercapto-succinic acid scan at 6 months postoperatively. We analyzed the preoperative studies and perioperative parameters to evaluate the factors affecting newly developed or aggravated hydronephrosis at 1 month, and decrease in differential renal function at 6 months after extravesical ureteral reimplantation. RESULTS: Newly developed or aggravated hydronephrosis was observed in 25 patients (28.4%) 1 month after extravesical ureteral reimplantation. Younger age at surgery was a risk factor (p = 0.003). Of the patients 23 showed improvement on ultrasound 6 months postoperatively. In 12 patients (15.7%) a decrease in differential renal function of more than 5% was observed 6 months postoperatively. Preoperative parenchymal reduction on dimercapto-succinic acid scan was the only significant factor (p = 0.008). There was no correlation between newly developed or aggravated hydronephrosis and final decrease in differential renal function (p >0.999). CONCLUSIONS: Although newly developed or aggravated hydronephrosis after extravesical ureteral reimplantation is common, especially in younger patients, it is transient and does not affect differential renal function. A postoperative decrease in differential renal function without further urinary tract infection could develop when there is a parenchymal reduction on preoperative dimercapto-succinic acid scan.
Full Text
http://www.sciencedirect.com/science/article/pii/S0022534711052633
DOI
22177200
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Yong Seung(이용승) ORCID logo https://orcid.org/0000-0003-3778-9888
Im, Young Jae(임영재)
Jung, Hyun Jin(정현진)
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
Hong, Chang Hee(홍창희) ORCID logo https://orcid.org/0000-0002-0946-7702
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/91184
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