Surgical management of high‐grade vesicoureteral reflux in an 18‐month‐old female with a solitary kidney: A case report from a resource‐limited setting

Author:

Nhungo Charles John1ORCID,Mwakalukwa Kelvin Richard1,Wambura Erasto Phares1,Kibona Herry Godfrey2,Mushi Fransia Arda1,Msangi Nimwindael Stephen3,Maro Isaack Mlatie2,Kimu Njiku Marko2,Nyongole Obadia Venance1,Mkony Charles A.1

Affiliation:

1. Department of Surgery, School of Medicine Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania

2. Department of Urology Muhimbili National Hospital Dar es salaam Tanzania

3. Department of Radiology Muhimbili National Hospital Dar es salaam Tanzania

Abstract

Key Clinical MessageConservative nonsurgical therapy ensures that the resolution is nearly 80% for vesicoureteral reflux grades I and II and 30%–50% for vesicoureteral reflux grades III and V within 4–5 years of follow‐up. Open surgical reimplantation of ureters of grades IV and V is a highly successful procedure, with reported correction rates ranging from 95% to 99% regardless of the severity of vesicoureteral reflux.AbstractPatients with vesicoureteral reflux present with a wide range of severity. With an incidence of approximately 1%, vesicoureteral reflux is a relatively common urological abnormality in children. Postnatal diagnosis of vesicoureteral reflux is typically made following a diagnosis of a urinary tract infection and less frequently following family screening. Voiding cystourethrograms remain the gold standard for diagnosing vesicoureteral reflux. To preserve the kidney and prevent the need for potential renal replacement therapy, infants with a single kidney require significantly more assessments and prompt decision‐making. Surgical correction is advised for patients with vesicoureteral reflux grades IV and V, while vesicoureteral reflux grades I, II, and III are managed conservatively.

Publisher

Wiley

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