Voiding Dysfunction after Bilateral Detrusorrhaphy to Correct Vesicoureteral Reflux in Children

Cho, Kang Su; Jeon, Hyung Jin; Lee, Hye Young; Han, Sang Won

Abstract

PURPOSE: We evaluated the incidence and duration of voiding dysfunction following bilateral detrusorrhaphy to correct vesicoureteral reflux (VUR), and we also evaluated the factors that influence the development of voiding dysfunction and recovery from voiding function.
MATERIALS AND METHODS
We performed a retrospective review on 36 children, 27 boys and 9 girls, who showed normal voiding function on preoperative video-urodynamic study and for whom data on post-void residual urine volume (PVR) were available postoperatively. The mean age and duration of follow-up were 3.1 2.6 years and 17.5 10.4 months, respectively. Postoperative voiding dysfunction included urinary retention and incomplete bladder emptying.
RESULTS
The overall success rate was 97.2%. The urethral catheter was kept in for a mean period of 4.0 3.6 days. After urethral catheter removal, postoperative voiding dysfunction developed in 24 children and urinary retention developed in 5 children. The differences in age, grade of VUR or sex did not have significant influence on the development of voiding dysfunction. 35 children achieved normal PVR during the postoperative follow-up. The mean time to recovery of voiding function was 34.1 37.9 days. The differences in age, sex or grade of VUR did not have any significant influence on the recovery rate of voiding function. The time to recovery of the voiding function was significantly longer in the patients aged less than 2 years or those patients with bilateral high-grade VUR. However, sex did not significantly influence the time to recovery of voiding function.
CONCLUSIONS
The development of postoperative voiding dysfunction is frequent, but temporary. However, it is necessary to consider a longer period of catheterization for the group of patients aged less than 2 years or those patients with bilateral high grade VUR.