Nerve sparing extravesical repair of bilateral vesicoureteral reflux: description of technique and evaluation of urinary retention

The Journal of Urology
Scott DavidDix P Poppas

Abstract

Prolonged urinary retention remains a controversial and feared complication following bilateral extravesical ureteral reimplantation. We report a modified approach to limit detrusor nerve damage during extravesical correction of bilateral ureteral reflux that significantly reduces this adverse outcome. A modified approach to the distal detrusor dissection and ureteral mobilization, along with limited periureteral dissection, was used to perform this technique. A retrospective review of 50 patients undergoing bilateral nerve sparing extravesical ureteral reimplantation (NSEVR) by a single surgeon between 1997 and 2002 was completed. Patient age, vesicoureteral reflux (VUR) grade, length of hospital stay, length of surgery and outcome were evaluated. The study included 36 girls and 14 boys, with an average age of 4 years 11 months (range 1 to 14 years). Average preoperative VUR grade was 2.61 (range 1 to 5). Average length of surgery when NSEVR was the only procedure performed was 105 minutes (range 54 to 185) and average length of hospital stay was 1.76 days (0 to 3). Transient urinary retention developed in 1 child on postoperative day 1, with a successful trial of voiding the next day. The rate of immediate urinary retention w...Continue Reading

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Citations

Dec 31, 2010·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Manuel LopezFrançois Varlet
Dec 3, 2014·The Urologic Clinics of North America·Megan S Schober, Venkata R Jayanthi
Sep 23, 2008·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Yao C TsaiStephen S D Yang
Jul 25, 2009·The Journal of Urology·Karim ChamieEric A Kurzrock
Aug 19, 2008·The Journal of Urology·Richard Ashley, David Vandersteen
May 24, 2006·Pediatric Clinics of North America·Larry A Greenbaum, Hrair-George O Mesrobian
Oct 12, 2005·The Journal of Urology·Scott PutmanPatrick Cartwright
Nov 16, 2016·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Krishnamoorthy Sriram, Ramesh Babu
Apr 11, 2019·Frontiers in Pediatrics·Aylin N Bilgutay, Andrew J Kirsch
Jan 22, 2017·Pediatric Surgery International·Martin A KoyleGrahame H H Smith
Apr 3, 2020·International Journal of Urology : Official Journal of the Japanese Urological Association·Hideshi MiyakitaMasayuki Kubota
Mar 26, 2020·Journal of Endourology·Niccolo Passoni, Craig A Peters

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