Surgical correction of vesico-ureteric reflux for recurrent febrile urinary tract infections after kidney transplantation

Authors


Correspondence: Ayhan Dinckan, Akdeniz Universitesi Organ Nakli Enstitusu, Dumlupınar Bulvari 07058 Kampus, Antalya, Turkey.

e-mail: adinckan@akdeniz.edu.tr

Abstract

Objective

  • To evaluate the outcome of anti-reflux revision surgery in patients diagnosed with at least a grade 3 reflux at voiding cysto-urethrography in patients with recurrent urinary tract infection (UTI) after renal transplantation.

Patients and Methods

  • We identified 60 patients with a diagnosis of recurrent febrile UTI and post-transplantation vesico-ureteric reflux (VUR) who underwent open surgical correction of reflux.
  • Patient characteristics, including the aetiology of end-stage renal disease, age, time to VUR correction, type of VUR correction, serum creatinine levels, and number of UTIs before and after correction were documented.

Results

  • The median (range) age of the patients was 31.5 (9–65) years. A total of 30 patients underwent uretero-ureterostomy or pyelo-ureterostomy and 30 underwent extravesical or intravesical ureteric reimplantation.
  • The median (range) creatinine levels before and after correction were 1.5 (0.8–4.5) mg/dL and 1.3 (0.7–4.5) mg/dL (P < 0.05), respectively.
  • The median (range) number of UTI episodes reported before the correction surgery was 4 (3–12), whereas number of UTI episodes after the surgery was 1 (0–12), the difference being significant (P < 0.05).

Conclusions

  • Open surgical correction of post-transplant VUR is an effective and safe method of decreasing UTI episodes and stopping reflux.
  • Surgical correction of reflux may prolong the life of the renal graft.

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