Surgical correction of vesico-ureteric reflux for recurrent febrile urinary tract infections after kidney transplantation

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Dinckan A., Aliosmanoglu I., KOÇAK H., Gunseren F., MESCİ A., ERTUĞ Z., ...Daha Fazla

BJU INTERNATIONAL, cilt.112, sa.4, 2013 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 112 Sayı: 4
  • Basım Tarihi: 2013
  • Doi Numarası: 10.1111/bju.12016
  • Dergi Adı: BJU INTERNATIONAL
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Anahtar Kelimeler: kidney transplantation, urinary tract infection, vesico-ureteric reflux, ureteric reimplantation, ureteroureterostomy, pyeloureterostomy, RENAL-TRANSPLANTATION, COMPLICATIONS
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Objective To evaluate the outcome of anti-reflux revision surgery in patients diagnosed with at least a grade 3 reflux at voiding cysto-urethrography in patients with recurrent urinary tract infection (UTI) after renal transplantation.

OBJECTIVE:

To evaluate the outcome of anti-reflux revision surgery in patients diagnosed with at least a grade 3 reflux at voiding cysto-urethrography in patients with recurrent urinary tract infection (UTI) after renal transplantation.

PATIENTS AND METHODS:

We identified 60 patients with a diagnosis of recurrent febrile UTI and post-transplantation vesico-ureteric reflux (VUR) who underwent open surgical correction of reflux. Patient characteristics, including the aetiology of end-stage renal disease, age, time to VUR correction, type of VUR correction, serum creatinine levels, and number of UTIs before and after correction were documented.

RESULTS:

The median (range) age of the patients was 31.5 (9-65) years. A total of 30 patients underwent uretero-ureterostomy or pyelo-ureterostomy and 30 underwent extravesical or intravesical ureteric reimplantation. The median (range) creatinine levels before and after correction were 1.5 (0.8-4.5) mg/dL and 1.3 (0.7-4.5) mg/dL (P<0.05), respectively. The median (range) number of UTI episodes reported before the correction surgery was 4 (3-12), whereas number of UTI episodes after the surgery was 1 (0-12), the difference being significant (P<0.05).

CONCLUSIONS:

Open surgical correction of post-transplant VUR is an effective and safe method of decreasing UTI episodes and stopping reflux. Surgical correction of reflux may prolong the life of the renal graft.