Simforoosh N, Hariri H. Management of vesicoureteral reflux without indwelling catheter and drain, using trigonoplasty technique.
J Pediatr Urol 2008;
4:445-7. [PMID:
18678530 DOI:
10.1016/j.jpurol.2008.06.004]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2008] [Accepted: 06/17/2008] [Indexed: 11/17/2022]
Abstract
PURPOSE
Gil-Vernet trigonoplasty is a simple, fast and effective technique for treating primary VUR, and is the only technique used to manage unilateral reflux that does not result in contralateral new reflux, due to its inherent bilateral nature. We have tried to further simplify postoperative management of the procedure by eliminating the use of an indwelling urethral catheter and drain.
PATIENTS AND METHODS
In a prospective study during a 15-month period, 65 children with 103 refluxing units (56 girls, nine boys), aged 1-15 years, underwent the designed surgery.
RESULTS
Preoperative voiding cystourethrogram revealed bilateral reflux in 38 and unilateral reflux in 27 children. Of 130 renal units, 103 were associated with reflux grade I, II, III, IV and V in 8.73%, 24.27%, 35.92%, 30.9% and 0.9% units, respectively. Of 103 refluxing units, 97 units had stopped refluxing on cystogram 3 months after surgery, giving the overall success rate of 94.1% for all grades of reflux included in the study. Only 7.6% of the children needed urethral catheterization after surgery. No ureteral obstruction occurred. Two patients developed urinary extravasation, both managed conservatively. No patient needed reoperation. The procedure was done on an outpatient basis in 40% of cases, while 60% of the children were hospitalized with a mean admission time of 3.4 days.
CONCLUSION
The Gil-Vernet trigonoplasty technique is simple, safe and effective. Our study further simplified postoperative management by avoiding an indwelling catheter and drain. Also, we have shown that this can be done as an outpatient procedure.
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