Prenatal complicated duplex collecting system and ureterocele-Important risk factors for urinary tract infection

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Visuri , S , Jahnukainen , T & Taskinen , S 2018 , ' Prenatal complicated duplex collecting system and ureterocele-Important risk factors for urinary tract infection ' , Journal of Pediatric Surgery , vol. 53 , no. 4 , pp. 813-817 . https://doi.org/10.1016/j.jpedsurg.2017.05.007

Title: Prenatal complicated duplex collecting system and ureterocele-Important risk factors for urinary tract infection
Author: Visuri, Sofia; Jahnukainen, Timo; Taskinen, Seppo
Contributor: University of Helsinki, Children's Hospital
University of Helsinki, Lastenkirurgian yksikkö
Date: 2018-04
Language: eng
Number of pages: 5
Belongs to series: Journal of Pediatric Surgery
ISSN: 0022-3468
URI: http://hdl.handle.net/10138/301791
Abstract: Purpose: To evaluate the risk of urinary tract infections (UTIs) in infants with prenatally detected complicated duplex collecting system (CDS) or ureterocele. Materials and methods: All patients with prenatally detected CDS (n= 34) or single system ureterocele (n= 7) who were admitted to our institution between 2003 and 2013 were enrolled in this retrospective analysis. Duplex collecting systems with ureterocele (n = 13), vesicoureteral reflux (VUR) (n = 20) or nonrefluxing megaureter without ureterocele (n = 7) were determined as complicated. Twenty-six (63%) patients were females. The prevalence of UTI was compared to 66 controls. Results: The median follow-up time was 5.5 (1.7-12.2) years. Eighteen (44%) patients and 3 (5%) controls had at least one UTI (p <0.001) at themedian age of 0.8 and 0.4 years, respectively (p= 0.481). Fifty-seven percent of the UTIs were breakthrough infections and 82% of those were non-Escherichia coli infections. UTIs occurred prior to any surgical intervention in 4/13 (31%) patients with ureterocele, in 2/14 (14%) patientswith VUR, in 4/7 (57%) patients with both ureterocele and VUR, and in 3/7 (43%) patientswith nonrefluxingmegaureterwithout VUR or ureterocele (p-values 0.012, 0.209, 0.001 and 0.010, respectively, compared to controls). Postoperative UTIswere observed in 29% of the girls and in none of the 11 boys (p = 0.072). The incidence of UTI after perforation of ureterocele was only 14%. Conclusions: Children with prenatally detected ureterocele or duplex collecting system associated with nonrefluxing megaureter are at high risk of UTI despite prophylactic antibiotics. In case of prenatally detected ureterocele we suggest to consider early endoscopic perforation. Level of evidence: III. (c) 2017 Elsevier Inc. All rights reserved.
Subject: Duplex collecting system
Prenatal
Ureterocele
Urinary tract infection
Vesicoureteral reflux
UPPER POLE HEMINEPHRECTOMY
VESICOURETERAL REFLUX
ENDOSCOPIC PUNCTURE
CHILDREN
DUPLICATION
DIAGNOSIS
INFANTS
3126 Surgery, anesthesiology, intensive care, radiology
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