Long-term incidence of urinary tract infection after ureteral reimplantation for primary vesicoureteral reflux

ObjectiveTo determine the incidence of urinary tract infection (UTI) after ureteral reimplantation (UR) for primary vesicoureteral reflux (VUR).Materials and methodsIn this retrospective review, the pyelonephritis-free survival of patients with primary VUR who underwent open UR from January 1990 to December 2002 was assessed using a Cox proportional hazards analysis.Results1076 patients underwent open UR for primary VUR. 73.0% were female; median age was 4.7 years. 80.1% presented with UTI. Clinical success rate for non-tapered UR was 96.5%. Median follow-up was 2.9 years. 21.8% had at least one postoperative UTI. 6.5% had postoperative pyelonephritis (POP) at a median of 21 months postoperatively. On multivariate survival analysis female gender (OR 9.97, 95% CI 3.07–32.34), preoperative VUR grade ≥3 (2.14, 1.25–3.69), breakthrough preoperative UTI (2.00, 1.22–3.25), and preoperative renal scarring (1.86, 1.15–2.99) were associated with POP.ConclusionPOP is rare on long-term follow-up, suggesting that UR is effective in reducing pyelonephritis in this population.