Pediatric Urology

[Margarita]

My 17 month old daughter had Bilateral Ureteral Reimplantion surgery at 11 months old. (she had very bad Grade 4 Reflux and Prophylaxsis didn't help at all) Her surgery was diagnosed a success 6 weeks post op using renal ultrasound. She had a UTI at 16 months, and now again at 17 months. I am worried that the surgery didn't work. Has anyone had an experience like this? And what was the outcome/diagnosis? I am hoping it is just bad luck. Any advice or input would help. I am so troubled by the thought that she will have to go thru another surgery attempt. Please help. Thanks.

[Teresa123]

Our surgeon said that success rates after ureteral reimplantation surgery are very high and the risk to operate on a child was less than 1%. My daughter had reflux grade IV and had an operation in May and is still taking antibiotics. You can read more about our story here http://ureteralreimplant.wordpress.com/

[MyKidsRock]

Have your daughter's infections remained in her lower tract, or have they moved into her kidney? If they are not moving into the kidneys then she could just be prone to uti. Reimplantation can't actually prevent a uti, only prevent it from moving into the kidney. So if the infections have remained in the bladder, I would consider that a good sign.

If she is getting kidney infections, I would want another vcug. It is not uncommon to get one infection shortly after surgery, but I might be concerned with two. As the previous poster stated, the success rate for reimplantation are between 95-99%, so the odds are definitely in your favor.

My daughter had reimplantation at 5 months of age. She also did not respond to antibiotics, and we were struggling with resistent strains of bacteria. Unfortunately, she has continued to have infections even after the surgery. I don't at all want to worry you, most surgeries are successful. My daughters case is complicated, involving duplicated ureters and an enlarged bladder, and possible other underlying causes.

There has been some research done on deflux injection for correction of vur after a failed reimplant, with very positive outcomes. I believe it was over 80%, but I will have to dig up the old articles. If I find them, I will send you a link. I believe there has also been good success with tapering of the ureters.

Hope some of this helps!

[Teresa123]

Thank you for your comprehensive response.

My daughter had a number of other things done too, apart from reimplantation. She was lucky that all her infections for the past 5 years have been confined to her bladder (an ureterocele was most likely stopping infections to go up to the kidney the surgeon said) and at the time of the operation she did´t have any kidney scarring. We decided to operate because being on antibiotics all the time was just not a solution anymore.

This year she was off antibiotics for a couple of months between operations and she was fine. No infections. This was after the partial nephrectomy to remove one of her duplex collecting system.

Our surgeon said that the need to operate again after ureter reimplantation is less than 1% for his patients so I hope she´ll be ok because we´re not going to operate in a hurry after the postoperative ordeal with bladder spasms she experienced.

She´s due for an ultrasound in a couple of weeks and also at that time we expect to stop the antibiotics.

Teresa
http://ureteralreimplant.wordpress.com/