Marchand Monique, Kuffer François, Tönz Martin
Klinik Siloah, 3073 Gümligen, Switzerland.
J Pediatr Urol. 2007 Jun;3(3):178-83. doi: 10.1016/j.jpurol.2006.09.006. Epub 2006 Nov 13.
The purpose of ureterocystoneostomy to correct vesicoureteral reflux is to thereby prevent recurrent febrile urinary tract infections (UTIs). The objective of this study was to determine the frequency of UTI in adult women who underwent reimplantation as children, with the emphasis on infections during pregnancy.
Included in the study were women over 20 years of age who underwent surgery for primary reflux between 1969 and 2004. A total of 392 patients were identified and information on their case history, surgery and follow-up was collected from the medical records. A questionnaire, requesting information on their present state of health, and occurrences of lower or upper UTI since the age of 16 and during any pregnancies, was sent to 337 of these patients.
In all, 242 (84%) of the questionnaires were returned. UTIs had occurred in 42% of the women before they had any sexual activity; thereafter the frequency increased to 61%. In 113 of the 282 women, 242 pregnancies were recorded. UTI occurred during 59 pregnancies (24%): 19% lower, 5% upper. Risk factors for UTI during pregnancy were infections as adults or decreased differential renal function (< or = 30%).
There is an ongoing risk of UTI in adult women after anti-reflux surgery in childhood. During pregnancy, these women represent a population at risk who should be observed very closely.
输尿管膀胱吻合术纠正膀胱输尿管反流的目的是预防复发性发热性尿路感染（UTI）。本研究的目的是确定儿童时期接受再植手术的成年女性中UTI的发生率，重点关注孕期感染情况。
研究纳入了1969年至2004年间因原发性反流接受手术的20岁以上女性。共识别出392例患者，并从病历中收集了她们的病史、手术及随访信息。向其中337例患者发送了一份问卷，询问她们目前的健康状况，以及自16岁以来和孕期发生下尿路感染或上尿路感染的情况。
共收回242份（84%）问卷。42%的女性在有任何性活动之前就发生过UTI；此后发生率增至61%。282例女性中有113例记录了242次妊娠。59次妊娠（24%）期间发生了UTI：下尿路感染19%，上尿路感染5%。孕期UTI的危险因素是成年期感染或肾功差异降低（≤30%）。
儿童期抗反流手术后成年女性存在持续的UTI风险。孕期，这些女性属于高危人群，应密切观察。
