Manzoni G A, Giacomoni M A, Cucchi L, Contorni L
Divisione di Chirurgia Pediatrica, Ospedale Niguarda, Milano, Italia.
Pediatr Med Chir. 1988 Jan-Feb;10(1):89-92.
Persistence of urinary tract infections after successful ureteric reimplantation for vesico-ureteric reflux has been reported with an incidence varying between 20-30% according to different series. The Authors analyze their own experience with 99 patients successfully operated for primary VUR during a five year period. In 22 patients (22.2%) there was evidence of persistent UTI, which were almost exclusively low and asymptomatic (91%) and occurring within 6-12 months after the antireflux surgery. A single UTI was documented in over 60% of the patients. There was strong female prevalence (21 patients) and 50% were more than 6 years old. No significant relationship was found between grade of VUR, renal scarring, type of germ and number of preoperative infections and incidence of post-operative UTI. On the other end, voiding and continence disorders and cystoscopic evidence of cystitis cystica would both indicate to be predisposing factors. In these specific cases it is mandatory an accurate pre-operative evaluation of the voiding habits, in order to better define the treatment strategy, not only limited to the surgical correction of the associated reflux.
据不同系列报道,输尿管再植术成功治疗膀胱输尿管反流后,尿路感染持续存在的发生率在20%至30%之间。作者分析了他们自己在五年期间对99例原发性膀胱输尿管反流成功手术患者的经验。22例患者(22.2%)有持续性尿路感染的证据,几乎均为轻度且无症状(91%),并发生在抗反流手术后6至12个月内。超过60%的患者记录有单次尿路感染。女性患病率较高(21例患者),50%的患者年龄超过6岁。未发现膀胱输尿管反流分级、肾瘢痕形成、细菌类型、术前感染次数与术后尿路感染发生率之间存在显著关系。另一方面,排尿和控尿障碍以及膀胱囊性膀胱炎的膀胱镜检查证据均表明是易感因素。在这些特定情况下,必须对排尿习惯进行准确的术前评估,以便更好地确定治疗策略,而不仅限于对相关反流的手术矫正。