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Persistent vesicoureteral reflux in a pediatric patient: case report and literature review
Persistent vesicoureteral reflux in a pediatric patient: case report and literature review
Wendy M. Chipa-Beizaga 1 
, Maria G. Medina-Mendez 2 , María P. Cateriano-Alberdi 3 , Gaudi A. Quispe-Flores 4 , Evelyn F. Sedano-Solorzano 4 , Luis J. Orbegoso-Celis 1
1 Unidad de Urología Pediátrica, Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú; 2 Unidad de Cirugía Pediátrica, Hospital Nacional 2 de Mayo, Lima, Perú; 3 Servicio de Urología, Hospital III Suárez Angamos, Lima, Perú; 4 Unidad de Nefrología Pediátrica, Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú
*Correspondence: Wendy M. Chipa-Beizaga, Email not available
Abstract
Introduction: Vesicoureteral reflux (VUR) is the non-physiological retrograde passage of urine from the bladder to the upper urinary tract. The estimated prevalence of VUR in humans is 1-2% of the general population. Clinical case: We present the case of an 8-year-old female patient with a prenatal diagnosis of stage IV vesicoureteral reflux. Due to persistent febrile urinary tract infections and increasing hydronephrosis, a left ureterostomy was performed at age 4. Subsequently, the ureterostomy was closed, and the left ureter was reimplanted. The patient again experienced urinary tract infections and persistent vesicoureteral reflux. Renal exclusion was confirmed with a differential renal function of 14% on DTPA renography, and a left nephroureterectomy was performed. Currently, the patient is free of urinary tract infections and has a favorable prognosis. Conclusions: Conservative management of persistent VUR after ureterovesical reimplantation was not feasible; therefore, nephroureterectomy was indicated due to ongoing urinary tract infections and renal scarring.
Keywords: Vesicoureteral reflux. Ureterostomy. Urinary tract infection. Ureteral reimplantation. Nephroureterectomy.
