NATURAL-HISTORY OF REFLUXING DISTAL URETERAL STUMPS AFTER NEPHRECTOMYAND PARTIAL URETERECTOMY FOR VESICOURETERAL REFLUX

Purpose: We evaluated the natural, history of refluxing distal uretera l stumps after nephrectomy and partial ureterectomy. Materials and Met hods: Between 1985 to 1996, 38 patients a mean age of 37 months underw ent nephrectomy and partial ureterectomy for reflux into a nonfunction ing kidney. The diagnosis included primary reflux in 23 patients, refl ux associated with posterior urethral valves in 10 and ipsilateral ure terocele in 5, Mean followup was 45 months. Results: Only 1 patient wi th an ipsilateral, ureterocele and 1 with contralateral reflux (5%) ha d symptomatic infections during postoperative followup, and each under went a secondary procedure to remove the ureteral stump. No patient wi th only primary unilateral reflux required surgery for the refluxing s tump. Conclusions: Because of the low risk of morbidity associated wit h a refluxing ureteral stump, we recommend nephrectomy and proximal ur eterectomy in patients with reflux into a nonfunctioning kidney.