Natural history of refluxing distal ureteral stumps after nephrectomy and partial ureterectomy for vesicoureteral reflux.

摘要

PURPOSE: We evaluated the natural history of refluxing distal ureteral stumps after nephrectomy and partial ureterectomy. MATERIALS AND METHODS: Between 1985 to 1996, 38 patients a mean age of 37 months underwent nephrectomy and partial ureterectomy for reflux into a nonfunctioning kidney. The diagnosis included primary reflux in 23 patients, reflux associated with posterior urethral valves in 10 and ipsilateral ureterocele in 5. Mean followup was 45 months. RESULTS: Only 1 patient with an ipsilateral ureterocele and 1 with contralateral reflux (5%) had symptomatic infections during postoperative followup, and each underwent a secondary procedure to remove the ureteral stump. No patient with only primary unilateral reflux required surgery for the refluxing stump. CONCLUSIONS: Because of the low risk of morbidity associated with a refluxing ureteral stump, we recommend nephrectomy and proximal ureterectomy in patients with reflux into a nonfunctioning kidney.