Heavy Scarring in the Unilateral Refluxing Kidney May Sign of Contralateral Reflux After Reimplantation

Abstract

Objective: The aim of this study was to investigate the role of heavy ipsilateral scarring in the development of the contralateral reflux after unilateral reimplantation. Materials and Methods: The study included 43 patients (24 male, 19 female) who had undergone unilateral reimplantation. Heavy scarring was defined as the presence of multiple central scars on renal scan and differential function of less than 30% with diffuse paraenchymal damage. Postoperative voiding cystourethrography was performed to evaluate febrile urinary tract infection or hydronephrosis during follow-up. The development of the contralateral reflux was compared based on the type of reimplantation, age, preoperative renal scar status, and reflux grade. Results: Contralateral reflux developed in 6 children. No significant relationship was found between the pre-operative grade, type of reimplantation, and incidence of the contralateral reflux. However, de novo contralateral reflux was significantly higher in children with heavy scarring on the ipsilateral kidney. Among the five children with heavy kidney scarring and aged 4 years or younger, contralateral reflux was found in three children. Reflux was resolved within 24.6±12.2 months on average although one child recovered with Dx/HA implantation. Conclusion: We found that the presence of heavy scarring in the ipsilateral kidney may play a role in the prediction of contralateral reflux development.

Keywords

• child-preschool
• renal scarring
• vesicoureteral reflux