Febrile Urinary Tract Infection After Ureteroneocystostomy

A Contemporary Assessment at a Single Institution

Benjamin Whittam, James R. Thomasch, John H. Makari, Stacy T. Tanaka, John C. Thomas, John C. Pope IV, Mark C. Adams, John W. Brock

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: Febrile urinary tract infection represents significant morbidity in patients with vesicoureteral reflux, especially following open surgical or endoscopic treatment. The reported incidence of febrile urinary tract infection after ureteroneocystostomy varies from 10% to 24%. We investigated the incidence of febrile urinary tract infection following ureteroneocystostomy in a contemporary, single institution series. Materials and Methods: We retrospectively reviewed medical records of 395 consecutive patients undergoing ureteroneocystostomy for primary vesicoureteral reflux at our institution between 2002 and 2007. We examined demographic, diagnostic and operative data, including presence of postoperative febrile urinary tract infection. A Cox proportional hazards model was performed to assess predictors of febrile urinary tract infection following ureteroneocystostomy. Results: Ureteroneocystostomy was performed in 395 patients (673 ureters) at a mean age of 58 months. The most common reflux grade was III (41%). The incidence of postoperative febrile urinary tract infection was 4.6% at a mean followup of 15 months. Postoperative dysfunctional elimination syndrome was a significant predictor of febrile urinary tract infection (HR 3.8, 95% CI 1.2-12, p = 0.02), and was identified in 58 of 340 toilet trained children (15% overall). Age at diagnosis, initial presentation, age at surgery, indication for surgery, reflux grade, laterality, surgical technique and preoperative dysfunctional elimination syndrome were not predictive of postoperative febrile urinary tract infection. Conclusions: The incidence of febrile urinary tract infection following ureteroneocystostomy may be lower than previously reported. The presence of postoperative dysfunctional elimination syndrome is a significant predictor of postoperative febrile urinary tract infection.

Original languageEnglish (US)
Pages (from-to)688-693
Number of pages6
JournalJournal of Urology
Volume183
Issue number2
DOIs
StatePublished - Feb 2010
Externally publishedYes

Fingerprint

Urinary Tract Infections
Fever
Vesico-Ureteral Reflux
Incidence
Ureter
Proportional Hazards Models
Medical Records
Demography
Morbidity

Keywords

  • pyelonephritis
  • urinary tract infections
  • urologic surgical procedures
  • vesico-ureteral reflux

ASJC Scopus subject areas

  • Urology

Cite this

Whittam, B., Thomasch, J. R., Makari, J. H., Tanaka, S. T., Thomas, J. C., Pope IV, J. C., ... Brock, J. W. (2010). Febrile Urinary Tract Infection After Ureteroneocystostomy: A Contemporary Assessment at a Single Institution. Journal of Urology, 183(2), 688-693. https://doi.org/10.1016/j.juro.2009.10.039

Febrile Urinary Tract Infection After Ureteroneocystostomy : A Contemporary Assessment at a Single Institution. / Whittam, Benjamin; Thomasch, James R.; Makari, John H.; Tanaka, Stacy T.; Thomas, John C.; Pope IV, John C.; Adams, Mark C.; Brock, John W.

In: Journal of Urology, Vol. 183, No. 2, 02.2010, p. 688-693.

Research output: Contribution to journalArticle

Whittam, B, Thomasch, JR, Makari, JH, Tanaka, ST, Thomas, JC, Pope IV, JC, Adams, MC & Brock, JW 2010, 'Febrile Urinary Tract Infection After Ureteroneocystostomy: A Contemporary Assessment at a Single Institution', Journal of Urology, vol. 183, no. 2, pp. 688-693. https://doi.org/10.1016/j.juro.2009.10.039
Whittam, Benjamin ; Thomasch, James R. ; Makari, John H. ; Tanaka, Stacy T. ; Thomas, John C. ; Pope IV, John C. ; Adams, Mark C. ; Brock, John W. / Febrile Urinary Tract Infection After Ureteroneocystostomy : A Contemporary Assessment at a Single Institution. In: Journal of Urology. 2010 ; Vol. 183, No. 2. pp. 688-693.
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N2 - Purpose: Febrile urinary tract infection represents significant morbidity in patients with vesicoureteral reflux, especially following open surgical or endoscopic treatment. The reported incidence of febrile urinary tract infection after ureteroneocystostomy varies from 10% to 24%. We investigated the incidence of febrile urinary tract infection following ureteroneocystostomy in a contemporary, single institution series. Materials and Methods: We retrospectively reviewed medical records of 395 consecutive patients undergoing ureteroneocystostomy for primary vesicoureteral reflux at our institution between 2002 and 2007. We examined demographic, diagnostic and operative data, including presence of postoperative febrile urinary tract infection. A Cox proportional hazards model was performed to assess predictors of febrile urinary tract infection following ureteroneocystostomy. Results: Ureteroneocystostomy was performed in 395 patients (673 ureters) at a mean age of 58 months. The most common reflux grade was III (41%). The incidence of postoperative febrile urinary tract infection was 4.6% at a mean followup of 15 months. Postoperative dysfunctional elimination syndrome was a significant predictor of febrile urinary tract infection (HR 3.8, 95% CI 1.2-12, p = 0.02), and was identified in 58 of 340 toilet trained children (15% overall). Age at diagnosis, initial presentation, age at surgery, indication for surgery, reflux grade, laterality, surgical technique and preoperative dysfunctional elimination syndrome were not predictive of postoperative febrile urinary tract infection. Conclusions: The incidence of febrile urinary tract infection following ureteroneocystostomy may be lower than previously reported. The presence of postoperative dysfunctional elimination syndrome is a significant predictor of postoperative febrile urinary tract infection.

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