Transitional Outcomes of Adults Who Underwent Cohen Ureteroneocystostomy for the Treatment of Vesicoureteral Reflux as Children
UROLOGY, cilt.198, ss.106-114, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 198
- Basım Tarihi: 2025
- Doi Numarası: 10.1016/j.urology.2024.12.006
- Dergi Adı: UROLOGY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, Gender Studies Database
- Sayfa Sayıları: ss.106-114
- İstanbul Üniversitesi Adresli: Evet
Özet
OBJECTIVE To analyze the transitional outcomes of children who underwent Cohen ureteroneocystostomy METHODS Files of patients who underwent UNC between January 2003 and December 2013 and had > 10 years of follow-up were retrospectively reviewed. Demographic and clinical data before surgery were noted. Lower urinary tract dysfunction (LUTD) status was assessed via ICIQ M/F-LUTS, voiding diary and uroflowmetry in all patients. Renal functions, hypertension, proteinuria, febrile/afebrile urinary tract infections(UTIs), and complications associated with pregnancy were noted. RESULTS Two hundred and forty-one patients (140 girls, 58.1%) underwent UNC at a median age of 6.5 years (3-14), and 57.7% underwent bilateral surgery. After a median follow-up of 15 years (1020), median patient age at the last clinic visit was 21 years (18-31). LUTD was detected in 69 function(BBD), presence of renal scar, and older age (>= 7 years) at the time of surgery were significantly associated with LUTD in adulthood. Febrile UTI was detected in 7.9% (19/241) following UNC, whereas 6 needed subureteral injection due to persistent low-grade VUR. No patient developed stage 3 or greater chronic kidney disease, but 11(4.6%) patients developed hypertension and 7(2.9%) had proteinuria. Of 67 sexually active female patients,10(14.9%) had febrile UTIs. Of 49 women in whom pregnancy was observed,4(8.1%) had febrile UTIs, 7(14.2%) had afebrile UTIs and 2(4.1%) had pre-eclampsia during pregnancy, but none had a miscarriage or early labor. CONCLUSION Despite VUR control, the incidence of febrile UTI and pre-eclampsia during pregnancy should not be underestimated. In addition, a quarter of patients face LUTD when they reach adulthood. Female patients with bilateral disease, renal scar, and previous childhood BBD have higher risks for these transitional clinical problems.