1980 Volume 71 Issue 9 Pages 1080-1087
Forty-four cases of nonobstructive vesicoureteral reflux (VUR) operated at the Department of Urology of Ehime University School of Medicine between 1976 and 1979 were examined and their results are reported.
Of the 44 cases, 14 cases, ranging in age from 5 to 50 years, were males and the remaining 30 cases, ranging in age from 4 to 57 years, were females and the incidence distributed about equally in all age groups in both male and female.
Of the 44 cases, 41 cases (91%) showed VUR greater than grade IIB and there was a significant correlation between the grade of the configuration of the ureteral orifice and that of VUR (p<0.05).
The incidence of previous upper urinary tract infection was 83% (38/44), whereas in 5 cases proteinuria was the only complaint and in one other case with undescended testicle, VUR was found incidentally.
Of the 44 cases, antireflux surgery was performed on 42 cases and nephroureterectomy on 2 cases, whose kidneys were markedly hypoplastic. As for antireflux surgery, Politano-Leadbetter procedure was performed on 26 cases (46 ureters), combined Politano-Leadbetter procedure on 4 cases (5 ureters), modified Paquin procedure on 12 cases (16 ureters). These cases were followed for periods ranging from 4 to 38 months. VUR recurred in only one case who underwent Politano-Leadbetter procedure and the occurrence of VUR in contralateral ureter after unilateral operation was noted in one case who underwent combined Politano-Leadbetter procedure. There was no radiological evidence of VUR or progressive deteriolation and no episode of pyelonephritic attack in the remaining cases.
We think that the majority of ureteral reimplantation for VUR can be done satisfactorily using a transvesical procedure (Politano-Leadbetter procedure) except when an extravesical approach is necessary or indicated for some reason.
Discussion was also made about operative techniques of transvesical procedure and postoperative management.
