Nine Year Retrospective Review of Surgical Treatment of Vesicoureteral Reflux: Comparison of Three Approaches
- *Corresponding Author:
- Miriam Harel
University of Connecticut Health Center
263 Farmington Avenue Farmington
CT 06030, USA
Tel: +1(347) 563-6110
Fax: +1(860) 545-9036
E-mail: [email protected]
Received date December 21, 2015; Accepted date May 28, 2016; Published date May 30, 2016
Citation: Harel M, Herbst KW, Silvis R, Makari JH, Ferrer FA, et al. (2016) Nine Year Retrospective Review of Surgical Treatment of Vesicoureteral Reflux: Comparison of Three Approaches. Adv Robot Autom 5:152. doi:10.4172/2168-9695.1000152
Copyright: © 2016 Harel M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: To analyze our nine-year experience in the surgical management of vesicoureteral reflux (VUR) with open ureteral reimplantation, robotic reimplantation, and endoscopic correction with Deflux. Methods: We retrospectively reviewed all patients undergoing surgical intervention for primary VUR at our institution between 2001 and 2010. Treatment success was defined as complete resolution of VUR on postoperative voiding cystourethrography. Surgeries were performed by four pediatric urologists. All robotic reimplantations were performed by a single surgeon. Categorical comparisons were made using Pearson’s Chi-Square or Fisher’s Exact test, and continuous variables were compared using Mann-Whitney U. Results: One hundred eighty-three patients (287 ureters) were included. Fourteen patients underwent robotic surgery, while the open surgery and Deflux cohorts included 93 and 76 patients, respectively. Due to the significantly smaller sample size of the robotic cohort, statistical comparisons were made only between the open surgery and Deflux cohorts. Postoperative VUR resolution rate was 100% (open), 85% (robotic), and 78.4% (Deflux). Open reimplantation had a significantly higher VUR resolution rate than Deflux (p<0.001). Overall, 13.9% of patients developed contralateral reflux, with no significant differences between the open and Deflux cohorts. Conclusions: In this study, we found significantly higher success rates with open reimplantation versus Deflux. While robotic reimplantation had high success rates and short hospital stays, the smaller sample size limited statistical comparison of this modality to open surgery or Deflux. We continue to enroll patients into a prospective series of all VUR procedures at our institution, which will result in more robust comparisons.