URINARY TRACT INFECTIONS AND PREGNANCY IN WOMEN WHO UNDERWENT ANTIREFLUX SURGERY IN CHILDHOOD
1998; Lippincott Williams & Wilkins; Volume: 159; Issue: 4 Linguagem: Inglês
10.1016/s0022-5347(01)63582-1
ISSN1527-3792
AutoresTimothy P. Bukowski, Glenn Betrus, Joseph W. Aquilina, Alan D. Perlmutter,
Tópico(s)Urological Disorders and Treatments
ResumoNo AccessJournal of UrologyClinical Urology: Original Articles1 Apr 1998URINARY TRACT INFECTIONS AND PREGNANCY IN WOMEN WHO UNDERWENT ANTIREFLUX SURGERY IN CHILDHOOD T.P. BUKOWSKI, G.G. BETRUS, J.W. AQUILINA, and A.D. PERLMUTTER T.P. BUKOWSKIT.P. BUKOWSKI (Bukowski) Requests for reprints: Pediatric Urology, 427 Burnett-Womack Bldg., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7235. More articles by this author , G.G. BETRUSG.G. BETRUS More articles by this author , J.W. AQUILINAJ.W. AQUILINA More articles by this author , and A.D. PERLMUTTERA.D. PERLMUTTER More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63582-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: For several decades ureteroneocystostomy has been performed in children to correct primary vesicoureteral reflux. A purported indication for antireflux surgery is to prevent significant upper urinary tract infection during pregnancy. We performed a long-term followup of women who underwent antireflux surgery during childhood to determine outcome in regard to urinary tract infection history and pregnancy. Materials and Methods: We identified 227 women of childbearing age who underwent ureteral reimplantation for primary vesicoureteral reflux from 1964 through 1981. Of the 122 women contacted 41 had been pregnant (77 total pregnancies). Cystitis or asymptomatic bacteriuria and pyelonephritis developed during 18 and 5 pregnancies, respectively. The 77 pregnancies resulted in 57 term births, 7 voluntary pregnancy interruptions and 13 spontaneous abortions. Results: Patients who previously underwent successful antireflux surgery continued to have a significant number of urinary tract infections through the intervening years. Despite a higher than expected incidence of pyelonephritis, they had relatively little hypertension and renal insufficiency. During pregnancy the incidence of pyelonephritis was only slightly higher than that of the general population. However, severe complications of pregnancy, such as preeclampsia, premature birth and acute renal failure, occurred more frequently in women with a history of renal scarring or hypertension (7 of 12) than in those with a history of recurrent infection alone (3 of 10). Conclusions: When renal scarring is present, reflux should be corrected before pregnancy to minimize maternal and fetal morbidity. When scarring is not present, the literature suggests that women with a history of reflux are at increased risk for pyelonephritis during pregnancy whether or not ureterocystostomy was performed. Pregnant women with a history of reflux may benefit from prophylactic antibiotics and women with reflux nephropathy should be followed throughout life. 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Google Scholar Department of Pediatric Urology, Children's Hospital of Michigan and Department of Urology, Wayne State University, Detroit, Michigan.© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByCHARBONNEAU S, TACKETT L, GRAY E, CAESAR R and CALDAMONE A (2018) IS LONG-TERM SONOGRAPHIC FOLLOWUP NECESSARY AFTER UNCOMPLICATED URETERAL REIMPLANTATION IN CHILDREN?Journal of Urology, VOL. 174, NO. 4 Part 1, (1429-1432), Online publication date: 1-Oct-2005.MOR Y, LEIBOVITCH I, FRIDMANS A, FARKAS A, JONAS P and RAMON J (2018) Late Post-reimplantation Ureteral Obstruction During Pregnancy: A Transient Phenomenon?Journal of Urology, VOL. 170, NO. 3, (845-848), Online publication date: 1-Sep-2003.Beetz R, Mannhardt W, Fisch M, Stein R and Thüroff J (2018) Long-Term Followup Of 158 Young Adults Surgically Treated For Vesicoureteral Reflux In Childhood: The Ongoing Risk Of Urinary Tract InfectionsJournal of Urology, VOL. 168, NO. 2, (704-707), Online publication date: 1-Aug-2002.HERNDON C, FERRER F and McKENNA P (2018) SURVEY RESULTS ON MEDICAL AND SURGICAL FOLLOWUP OF PATIENTS WITH VESICOURETERAL REFLUX FROM AMERICAN ASSOCIATION OF PEDIATRICS, SECTION ON UROLOGY MEMBERSJournal of Urology, VOL. 165, NO. 2, (559-563), Online publication date: 1-Feb-2001. Volume 159Issue 4April 1998Page: 1286-1289 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information T.P. BUKOWSKI (Bukowski) Requests for reprints: Pediatric Urology, 427 Burnett-Womack Bldg., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7235. More articles by this author G.G. BETRUS More articles by this author J.W. AQUILINA More articles by this author A.D. PERLMUTTER More articles by this author Expand All Advertisement PDF DownloadLoading ...
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