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Advances in Urology
Volume 2011, Article ID 352716, 5 pages
http://dx.doi.org/10.1155/2011/352716
Research Article

Surgical Reimplantation for the Correction of Vesicoureteral Reflux following Failed Endoscopic Injection

1Department of Urology, Shaare Zedek Medical Center, the Faculty of Medicine Hebrew University, Jerusalem, 91031, P.O. Box 3235, Israel
2Department of Urology, Bnai Zion Medical Center and the Faculty of Medicine, Technion Israel Institute of Technolog, 47 Golomb Street, Haifa 31048, Israel

Received 6 September 2010; Revised 23 November 2010; Accepted 8 December 2010

Academic Editor: Rita Gobet

Copyright © 2011 Boris Chertin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. In recent years, endoscopic injection became the procedure of choice for the correction of vesicoureteral reflux in the majority of the centers. Unfortunately, endoscopic treatment is not always successful and sometimes requires more than one trial to achieve similar results to that of an open reimplantation surgery. Our aim of this study is to evaluate the feasibility and success rate of open ureteral reimplantation following failed endoscopic procedure. Patients and Methods. During 2004–2010, we evaluated 16 patients with persistent vesicoureteral reflux (grades II–IV) following failed endoscopic treatment. All patients underwent open ureteral reimplantation. All patients were followed with an ultrasound 6 weeks following surgery and every 6 months thereafter for an average of 22 months. Voiding cystography was performed at 3 months after surgery. Results. During unilateral open ureteral reimplantation, the implanted deposit from previous procedures was either excised, drained, or incorporated into the neotunnel with the ureter. Vesicoureteral reflux was resolved in all patients with 100% success rate. No new hydronephrosis or signs of obstruction developed in any of the patients. qDMSA renal scan was available in 8 patients showing improvement of function in 5 and stable function in 3, and no new scars were identified. Conclusions. Open ureteral reimplantation is an excellent choice for the correction of failed endoscopic treatment in children with vesicoureteral reflux.