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Pediatric Surgery International

Erschienen in:

01.12.2023 | Original Article

Successful rescue pneumovesicoscopic surgery for post-Deflux^® vesicoureteral junction obstruction

verfasst von: Li-Yu Yang, Chia-Man Chou, Sheng-Yang Huang, Hou-Chuan Chen

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

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Abstract

Background

Vesicoureteral junction (VUJ) obstruction after Deflux^® subureteral injection for vesicoureteral reflux (VUR) is rare and minimally invasive management has not been reported. This work investigated the patients who underwent Deflux^® injection for VUR and identified those with subsequent VUJ obstruction.

Methods

Medical records of matched patients from October 2003 to March 2022 were reviewed, and parameters were retrospectively studied. All patients underwent Deflux^® injection. The injection was performed under general anesthesia using the same manner. For patients complicated with VUJ obstruction, the symptoms, signs, management, images, renal ultrasounds, Tc-99m dimercaptosuccinic acid renal scintigraphy, histology of VUJ region, and outcomes were documented and reported. VUJ stenosis was diagnosed by performing renal ultrasound and magnetic resonance imaging.

Results

Totally 407 patients (554 ureterorenal units) received Dx/HA injections for VUR. VUJ obstruction was found in three patients (four ureterorenal units). Originally, three were grade V VUR, and one was grade IV. The repeated injection was not a risk factor for VUJ obstruction. The overall incidence of VUJ obstruction post-Dx/HA injection was 0.7% by ureter. The incidences were 0%, 0.75%, and 2.25% for grade I–III, IV, and V VUR, respectively. After the initial conversion case of pneumovesicoscopic ureteral reimplantation, the procedure was performed smoothly and successfully in the two following cases.

Conclusions

Pneumovesicoscopic ureteral reimplantation offers an alternative for VUJ obstruction following Dx/HA injection for VUR. Fibrosis and foreign-body reaction may influence the feasibility. High-grade VUR and young age of injection were related to VUJ obstruction.

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Titel: Successful rescue pneumovesicoscopic surgery for post-Deflux® vesicoureteral junction obstruction
verfasst von: Li-Yu Yang
Chia-Man Chou
Sheng-Yang Huang
Hou-Chuan Chen
Publikationsdatum: 01.12.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-023-05538-3

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Successful rescue pneumovesicoscopic surgery for post-Deflux^® vesicoureteral junction obstruction

Abstract

Background

Methods

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Conclusions

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Background

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