Natural history of refluxing distal ureteral stumps after nephrectomy and partial ureterectomy for vesicoureteral reflux.

Abstract

We evaluated the natural history of refluxing distal ureteral stumps after nephrectomy and partial ureterectomy. Between 1985 to 1996, 38 patients a mean age of 37 months underwent nephrectomy and partial ureterectomy for reflux into a nonfunctioning kidney. The diagnosis included primary reflux in 23 patients, reflux associated with posterior urethral valves in 10 and ipsilateral ureterocele in 5. Mean followup was 45 months. Only 1 patient with an ipsilateral ureterocele and 1 with contralateral reflux (5%) had symptomatic infections during postoperative followup, and each underwent a secondary procedure to remove the ureteral stump. No patient with only primary unilateral reflux required surgery for the refluxing stump. Because of the low risk of morbidity associated with a refluxing ureteral stump, we recommend nephrectomy and proximal ureterectomy in patients with reflux into a nonfunctioning kidney.