Objectives: We report the outcome and incidence of urinary retention after bilateral extravesical reimplant in patients with primary vesicoureteral reflux.

Methods: We retrospectively evaluated the chart of 127 patients, 92 females and 35 males, who underwent correction of primary vesicoureteral reflux using the extravesical approach. Mean patient age at surgery was 3.93 years. Postoperatively the urethral catheter was removed after 24 to 72 hours and a voiding trial was done. Surgical outcomes were analyzed specifically for perioperative complications and resolution of reflux on postoperative VCUG.

Results: Mean follow-up was 4.01 years. Postoperative VCUG showed resolution of reflux in 122 (96%) patients. Urinary retention developed in 7/127 patients (5.5%). In 57 patients in whom the surgery was done from 06-1998 to 01-2001, urinary retention developed in 5/57 (8.7%) for 1 day (1), 2 days (1), 5 days (2) and 4 weeks (1). In 70 patients in whom the surgery was done from 02-2001 to 10-2006, urinary retention developed in 2/70 (2.85%) for 1 day (2).

Conclusions: Bilateral extravesical vesicoureteral reimplant can be associated with temporary urinary retention. In the last 5 years, with a careful and limited dissection close to the distal ureter and used of bipolar cautery when necessary, we were able to decreased the risk of postoperative urinary retention.

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http://dx.doi.org/10.4321/s0004-06142008000200031DOI Listing

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