Abstract
We have selected extravesical ureteral reimplantation for vesicoureteral reflux (VUR) since 2009 because hematuria and spasms are minimal. To clarify its efficacy and safety, we retrospectively evaluated the surgical outcomes of our extravesical ureteral reimplantation for VUR associated with paraureteral diverticula in children. Five patients (8 ureters) underwent extravesical ureteral reimplantation between 2009 and 2014. Two of them had unilateral VUR with ipsilateral diverticulum and 3 had bilateral VURs with bilateral diverticula. The median age of the 5 patients, 4 of whom were male, at surgery was 5.7 years old (range, 1.8–14.9). Mean follow-up duration was 49.4 months (range, 32–67). VUR was Grade I in no ureter, Grade II in 2 ureters, Grade III in 2 ureters, Grade IV in 3 ureters, and Grade V in 1 ureter. Patients with unilateral diverticulum could leave the hospital 1 day postoperatively, and patients with bilateral diverticula could leave the hospital 3 days postoperatively. No patient had febrile urinary tract infection after surgery. One patient had hydronephrosis at 3 weeks postoperatively, but none had hydronephrosis at 3 and 12 months postoperatively. Extravesical ureteral reimplantation is safe and effective for VUR associated with paraureteral diverticula in children because there are few complications and minimal perioperative morbidity.
