Personalized Surgical Management Offers Full Restitution and Unimpaired Quality of Life to Patients with Duplex Kidneys and Associated Pathologies: 30-year Follow-up at a Tertiary Referral Center.
Duplex kidney
Ectopic ureter
Heminephrectomy
Ureterocele
Ureterocystic reimplantation
Journal
European urology open science
ISSN: 2666-1683
Titre abrégé: Eur Urol Open Sci
Pays: Netherlands
ID NLM: 101771568
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
accepted:
20
09
2023
medline:
29
11
2023
pubmed:
29
11
2023
entrez:
29
11
2023
Statut:
epublish
Résumé
Duplex kidneys may be associated with additional pathologies with an indication for surgery. Various surgical approaches have been described. However, little is known about long-term outcomes and quality of life (QoL) for these patients. To present long-term outcomes and QoL data up to 30 yr after surgical treatment of duplex kidneys and associated pathologies. We collected clinical and operative data for all patients who underwent surgery for complicated duplex kidney at our institution from 1990 to 2018. All patients were invited for a follow-up examination or telephone interview. We evaluated renal function, clinical outcomes, residual dilation of the upper urinary tract, and health-related QoL. Of the 176 patients included, 173 were available for follow-up (mean 140.5 mo). Surgical treatment involved an upper-tract, lower-tract, or combined approach in 11%, 56%, and 33% of cases, respectively. Rates of perioperative complications (8%) and secondary surgery (10%) were low. Overall, 95% of our patients achieved full restitution. Renal function was preserved in all cases, with recurrent urinary tract infections reported by just 2% and urinary incontinence by 1%. Good health-related QoL was reported by 98% of patients. Those without full restitution included six patients who underwent total nephrectomy and two boys who underwent multiple surgeries and urinary diversion. Our results are limited by their retrospective nature, including partly incomplete data sets. Management of duplex kidneys and associated pathologies is complex and highly individual. By planning a personal approach for each patient it is possible to achieve full bodily integrity and good QoL for most of these patients. Almost all patients undergoing surgery for duplex kidneys and associated pathologies will lead a life without body impairment and good quality of life.This trial is registered in the German Clinical Trials Register as DRKS00022542.
Sections du résumé
Background
UNASSIGNED
Duplex kidneys may be associated with additional pathologies with an indication for surgery. Various surgical approaches have been described. However, little is known about long-term outcomes and quality of life (QoL) for these patients.
Objective
UNASSIGNED
To present long-term outcomes and QoL data up to 30 yr after surgical treatment of duplex kidneys and associated pathologies.
Design setting and participants
UNASSIGNED
We collected clinical and operative data for all patients who underwent surgery for complicated duplex kidney at our institution from 1990 to 2018. All patients were invited for a follow-up examination or telephone interview.
Outcome measurements and statistical analysis
UNASSIGNED
We evaluated renal function, clinical outcomes, residual dilation of the upper urinary tract, and health-related QoL.
Results and limitations
UNASSIGNED
Of the 176 patients included, 173 were available for follow-up (mean 140.5 mo). Surgical treatment involved an upper-tract, lower-tract, or combined approach in 11%, 56%, and 33% of cases, respectively. Rates of perioperative complications (8%) and secondary surgery (10%) were low. Overall, 95% of our patients achieved full restitution. Renal function was preserved in all cases, with recurrent urinary tract infections reported by just 2% and urinary incontinence by 1%. Good health-related QoL was reported by 98% of patients. Those without full restitution included six patients who underwent total nephrectomy and two boys who underwent multiple surgeries and urinary diversion. Our results are limited by their retrospective nature, including partly incomplete data sets.
Conclusions
UNASSIGNED
Management of duplex kidneys and associated pathologies is complex and highly individual. By planning a personal approach for each patient it is possible to achieve full bodily integrity and good QoL for most of these patients.
Patient summary
UNASSIGNED
Almost all patients undergoing surgery for duplex kidneys and associated pathologies will lead a life without body impairment and good quality of life.This trial is registered in the German Clinical Trials Register as DRKS00022542.
Identifiants
pubmed: 38020523
doi: 10.1016/j.euros.2023.09.012
pii: S2666-1683(23)01289-2
pmc: PMC10658413
doi:
Types de publication
Journal Article
Langues
eng
Pagination
106-112Informations de copyright
© 2023 The Author(s).
Références
J Urol. 2015 Aug;194(2):427-32
pubmed: 25640647
J Urol. 2015 May;193(5 Suppl):1754-9
pubmed: 25817139
Pediatr Radiol. 2008 Feb;38(2):138-45
pubmed: 18071685
Pediatr Nephrol. 2007 Nov;22(11):1839-48
pubmed: 17216261
Clin Radiol. 1969 Oct;20(4):387-400
pubmed: 5349344
Pediatr Clin North Am. 1997 Oct;44(5):1323-41
pubmed: 9326964
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
J Urol. 2000 Sep;164(3 Pt 2):1097-9; discussion 1099-100
pubmed: 10958751
Clin Chem. 2008 Mar;54(3):559-66
pubmed: 18202155
Eur Urol. 2002 Jul;42(1):63-6
pubmed: 12121732
J Pediatr Urol. 2020 Jun;16(3):387.e1-387.e8
pubmed: 32340881
Clin Lab. 2000;46(1-2):53-5
pubmed: 10745982
Kidney Int Suppl (2011). 2013 Jan;3(1):19-62
pubmed: 25018975
BJU Int. 2004 Jun;93(9):1313-7
pubmed: 15180630
Ann Med. 2001 Jul;33(5):337-43
pubmed: 11491192
J Pediatr. 1986 Oct;109(4):698-707
pubmed: 3761090
J Pediatr Urol. 2021 Feb;17(1):134-135
pubmed: 33357984
Urol Int. 2012;88(4):438-40
pubmed: 22398644
Pediatrics. 1976 Aug;58(2):259-63
pubmed: 951142
Health Policy. 1990 Dec;16(3):199-208
pubmed: 10109801
Am J Roentgenol Radium Ther Nucl Med. 1967 Mar;99(3):577-84
pubmed: 6020635
Clin Radiol. 1976 Oct;27(4):521-30
pubmed: 1000896
J Med Imaging Radiat Oncol. 2015 Apr;59(2):149-53
pubmed: 25708100