Castellan Miguel, Damiani Horacio, Fadil Iturralde José, Sanchez Mazzaferri Fabio, Yunes Jorge
Sanatorio de Niños de Rosario, Hospital de Niños V. J. Vilela, Rosario, Argentina.
Arch Esp Urol. 2003 Nov;56(9):1013-6.
To evaluate the necessity of performing ureteral reimplantation in patients with vesicoureteral reflux secondary to neurogenic bladder.
Retrospective review of 19 patients (10 males and 9 females), between 2 and 19 years of age (Mean age 7 years), with neurogenic bladder and vesicoureteral reflux (VUR) treated from May 1990 to July 2000. No one patient had a satisfactory response to the therapy with anticholinergic drugs and clean intermittent catheterization. All 19 patients underwent augmentation cystoplasty (15 using sigmoid colon and 4 ureter). Ten patients, 16 renal units, underwent simultaneous ureteral reimplantation.
All patients improved their bladder capacity and compliance after bladder augmentation. VUR disappeared in 17 patients. Two patients (3 renal units) in the group without ureteral reimplantation remained with a minor degree of reflux.
Bladder augmentation alone resolves VUR secondary to neurogenic bladder in a high percentage of patients.
评估对神经源性膀胱继发膀胱输尿管反流患者行输尿管再植术的必要性。
回顾性分析1990年5月至2000年7月间收治的19例（男10例，女9例）年龄在2至19岁（平均年龄7岁）的神经源性膀胱合并膀胱输尿管反流（VUR）患者。所有患者对抗胆碱能药物治疗及清洁间歇性导尿均无满意疗效。19例患者均接受了膀胱扩大术（15例采用乙状结肠，4例采用输尿管）。10例患者（16个肾单位）同时接受了输尿管再植术。
所有患者膀胱扩大术后膀胱容量及顺应性均得到改善。17例患者的VUR消失。未行输尿管再植术组的2例患者（3个肾单位）仍有轻度反流。
单纯膀胱扩大术可使大部分神经源性膀胱继发的VUR得到解决。
