Trigonal Splitting is a Major Complication of Endoscopic Trigonoplasty at 1-Year Followup |
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Authors: | Kikuo Okamura Norio Kato Shinichi Takamura Junji Tanaka Tatsuya Nagai Hiroyuki Watanabe Yoshikazu Tsuji Yoshinari Ono Shinichi Ohshima |
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Institution: | From the Department of Urology, Nagoya University School of Medicine, Nagoya, Japan |
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Abstract: | PurposeThe long-term results of endoscopic trigonoplasty in patients with vesicoureteral reflux were investigated.Materials and MethodsWe performed endoscopic trigonoplasty in 28 patients with vesicoureteral reflux, including 6 girls 6 to 8 years old. Reflux was grade I in 14 reno-ureteral units, grade II in 15, grade III in 8, grade IV in 1 and grade V in 1. Median followup was 23 months.ResultsAt a median of 3 months postoperatively vesicoureteral reflux was not apparent in 37 units (95%) and it was downgraded in 1 (3%). At a median of 12 months postoperatively 27 (79%) and 4 (12%) of the 34 ureters had cessation and downgrading, respectively. Of the 13 select patients who underwent cystoscopy 3 had retreating ureteral orifices and 5 had trigonal splitting 6 to 12 months postoperatively. Vesicoureteral reflux was demonstrated in 3 of the 5 patients (4 ureters) with trigonal splitting and in 1 (1 ureter) with retreating ureteral orifices. At a median of 24 months after surgery voiding cystography showed reflux in only 1 of 15 units. No postoperative upper urinary tract dilatation was noted at followup.ConclusionsCessation rates of vesicoureteral reflux 12 months after endoscopic trigonoplasty were low with a high incidence of trigonal splitting. These unsatisfactory results mandate technical refinements to avoid trigonal splitting. |
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