Primary Vesicoureteral Reflux - Extravesical Antireflux Plasty -

Kwon, Sung Won

Abstract

The vesicoureteral reflux is closely related to urinary tract infection in children and persistent vesicoureteral reflux with recurrent urinary tract infection is the common indication for antireflux plasty But it has been known that the vesicoureteral reflux was rare in Korea. From March 1979 to June 1984, author observed 13 patients with vesicoureteral reflux in the absence of any lower urinary tract obstruction, neuropathic disorder, inflammatory lesion at the base of the bladder, which were confirmed with IVP, VCUG and cystoscopy. The results were as follows 1. Age distribution was from 1 yr to 10 yr 2. Sex ratio of male to female was 1.1:1 3. Chief complaints at admission were fever 7 cases (53.9 %), flank pain 3 cases (23%), abdominal mass 2 cases (15.3%), incontinence 1 cases (7.6%). 4. Urinary culture at abmission revealed E. Coli in 9 patients (69%) and both E. Coli and Staphylococci in a patient. 5. 9 of 13 patients showed normal findings in IVP before treatment 6. 13 of 19 ureters showed one more than grade III in VCUG; before treatment. 7. In cystoscopy, shapes of 19 ureteral orifices with vesicoureteral reflux were golf-hole type 9 cases (47.4 %), horse-shoe type 2 cases (10.5 %), stadium type 1 case (5.2%), cone type 6 cases (31.6%) and in one case, it couldn`t be detected due to severe trabeculation. 8. Gregoir-Lich extravesical antireflux plasty were obtained in 13 of 19 ureters with vesicoureteral reflux without failure during four to seven follow-up months.