SIMFOROOSH N. A NEW APPROACH TO VESICOURETERAL REFLUX PERSISTING AFTER POSTERIOR URETHRAL VALVE ABLATION USING GIL-VERNET ANTIREFLUX TECHNIQUE. Med J Islam Repub Iran 1989; 2 (4) :249-254
URL:
http://mjiri.iums.ac.ir/article-1-1228-en.html
From the Department of Urology, Shahid Labbafi Nejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
Abstract: (4785 Views)
Classic anti reflux procedures on children with a history of posterior
urethral valve does not usually yield good results and often ends up with
ureteral obstruction and even permanent urinary diversion.
From 1981 through 1988,21 boys with history of posterior urethral valve
(PUV) underwent evaluation for vesicoureteral (VU) reflux 17 boys had
VU reflux. Following valve ablation, reflux disappeared in nine cases. Eight
boys continued to have reflux (average follow up after valve ablation was 17
months). The grade of refluxes was IV or higher in all of the cases. Gil-Vernet
anti reflux procedure was performed in these boys. VU reflux disappeared in
11 of 12 refluxing ureters in these eight boys postoperatively. An excellent
success rate (91.7% ) was seen without upper tract deterioration in any of the
cases. Average follow up was six months with the longest being 13 months.
This is the first report of the application of Gil-Vernet antireflux technique
in persistent reflux following valve ablation and seems a breakthrough in
managment of PUV refluxes, eliminating the need for preliminary diversion
as performed in the past.
We recommend this simple, highly effective approach as the procedure
of choice in managment of VU refluxes following valve ablation in children
with PUV.