New hydronephrosis and/or vesicoureteral reflux after bladder outlet surgery without augmentation in 75 children with neurogenic bladder

W. Snodgrass, C. Villanueva, P. Gargollo, M. Jacobs

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Objective: We report new upper tract changes in children after bladder neck (BN) surgery without augmentation for neurogenic incontinence. Materials and methods: Consecutive children with neurogenic sphincteric incompetency had BN surgery without augmentation. Postoperative renal sonography and fluoroscopic urodynamics were done at 6 months, 12 months, and then annually. Results: There were 75 patients with mean follow-up of 48 months. Of these, 17 (23%) developed new hydronephrosis (HN) or vesicoureteral reflux (VUR). All HN resolved with medical management, as did 25% of VUR cases. Persistent VUR was treated by dextranomer/hyaluronic acid injection, or re-implantation in two patients undergoing re-operative BN surgery. There was no association between these upper tract changes and end filling pressures (<40 cm vs. >40 cm) or continence status (dry vs. wet). Conclusions: Upper tract changes developed in 25% of patients with neurogenic bladders after BN surgery without augmentation during a follow-up of 48 months. All new HN and most new VUR resolved with medical management or minimally invasive intervention. No patient developed upper tract changes requiring augmentation.

Original languageEnglish (US)
Pages (from-to)906-910
Number of pages5
JournalJournal of Pediatric Urology
Volume10
Issue number5
DOIs
StatePublished - Jan 1 2014

Keywords

  • Augmentation
  • Bladder neck
  • Hydronephrosis
  • Neurogenic bladder
  • Vesicoureteral reflux

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Urology

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