Extravesical vs. intravesical ureteric reimplantation for primary vesicoureteral reflux: A systematic review and meta-analysis

PURPOSE: This study aims to compare the outcomes of extravesical (EVUR) and intravesical (IVUR) ureteric reimplantation for primary vesicoureteral reflux (VUR) via systematic review and meta-analysis. METHODS: Literature review from Medline, Embase, and Cochrane since inception to March 2022 was per...

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Autores principales: Law, Zhi Wei, Ong, Caroline C. P., Yap, Te-Lu, Loh, Amos H. P., Joseph, Udayan, Sim, Siam Wee, Ong, Lin Yin, Low, Yee, Jacobsen, Anette S., Chen, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9633941/
https://www.ncbi.nlm.nih.gov/pubmed/36340705
http://dx.doi.org/10.3389/fped.2022.935082
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author Law, Zhi Wei
Ong, Caroline C. P.
Yap, Te-Lu
Loh, Amos H. P.
Joseph, Udayan
Sim, Siam Wee
Ong, Lin Yin
Low, Yee
Jacobsen, Anette S.
Chen, Yong
author_facet Law, Zhi Wei
Ong, Caroline C. P.
Yap, Te-Lu
Loh, Amos H. P.
Joseph, Udayan
Sim, Siam Wee
Ong, Lin Yin
Low, Yee
Jacobsen, Anette S.
Chen, Yong
author_sort Law, Zhi Wei
collection PubMed
description PURPOSE: This study aims to compare the outcomes of extravesical (EVUR) and intravesical (IVUR) ureteric reimplantation for primary vesicoureteral reflux (VUR) via systematic review and meta-analysis. METHODS: Literature review from Medline, Embase, and Cochrane since inception to March 2022 was performed. Meta-analysis was conducted on eligible randomized controlled trials (RCT) and observational cohort studies (OCS) comparing outcomes between EVUR and IVUR. RESULTS: Twelve studies were included, comprising 577 patients (778 ureters) operated by EVUR and 395 patients (635 ureters) by IVUR. Pre-operative VUR grade, postoperative VUR persistence and hydronephrosis was not statistically significant. EVUR had shorter operative time [mean differences (MD) −22.91 min; 95% confidence interval (CI), −44.53 to −1.30, P = 0.04] and hospital stay (MD −2.09 days; 95% CI, −2.82 to −1.36, P < 0.00001) compared to IVUR. Bilateral EVUR had higher risk of postoperative acute urinary retention (ARU) (8.1%) compared to bilateral IVUR (1.7%) (OR = 4.40; 95% CI, 1.33–14.58, P = 0.02). No patient undergoing unilateral EVUR or IVUR experienced ARU. CONCLUSION: Both EVUR and IVUR are equally effective in correcting primary VUR. Operative time and hospital stay are shorter after EVUR compared to IVUR. However, bilateral EVUR is associated with higher risk of postoperative ARU.
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spelling pubmed-96339412022-11-05 Extravesical vs. intravesical ureteric reimplantation for primary vesicoureteral reflux: A systematic review and meta-analysis Law, Zhi Wei Ong, Caroline C. P. Yap, Te-Lu Loh, Amos H. P. Joseph, Udayan Sim, Siam Wee Ong, Lin Yin Low, Yee Jacobsen, Anette S. Chen, Yong Front Pediatr Pediatrics PURPOSE: This study aims to compare the outcomes of extravesical (EVUR) and intravesical (IVUR) ureteric reimplantation for primary vesicoureteral reflux (VUR) via systematic review and meta-analysis. METHODS: Literature review from Medline, Embase, and Cochrane since inception to March 2022 was performed. Meta-analysis was conducted on eligible randomized controlled trials (RCT) and observational cohort studies (OCS) comparing outcomes between EVUR and IVUR. RESULTS: Twelve studies were included, comprising 577 patients (778 ureters) operated by EVUR and 395 patients (635 ureters) by IVUR. Pre-operative VUR grade, postoperative VUR persistence and hydronephrosis was not statistically significant. EVUR had shorter operative time [mean differences (MD) −22.91 min; 95% confidence interval (CI), −44.53 to −1.30, P = 0.04] and hospital stay (MD −2.09 days; 95% CI, −2.82 to −1.36, P < 0.00001) compared to IVUR. Bilateral EVUR had higher risk of postoperative acute urinary retention (ARU) (8.1%) compared to bilateral IVUR (1.7%) (OR = 4.40; 95% CI, 1.33–14.58, P = 0.02). No patient undergoing unilateral EVUR or IVUR experienced ARU. CONCLUSION: Both EVUR and IVUR are equally effective in correcting primary VUR. Operative time and hospital stay are shorter after EVUR compared to IVUR. However, bilateral EVUR is associated with higher risk of postoperative ARU. Frontiers Media S.A. 2022-10-21 /pmc/articles/PMC9633941/ /pubmed/36340705 http://dx.doi.org/10.3389/fped.2022.935082 Text en Copyright © 2022 Law, Ong, Yap, Loh, Joseph, Sim, Ong, Low, Jacobsen and Chen. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Law, Zhi Wei
Ong, Caroline C. P.
Yap, Te-Lu
Loh, Amos H. P.
Joseph, Udayan
Sim, Siam Wee
Ong, Lin Yin
Low, Yee
Jacobsen, Anette S.
Chen, Yong
Extravesical vs. intravesical ureteric reimplantation for primary vesicoureteral reflux: A systematic review and meta-analysis
title Extravesical vs. intravesical ureteric reimplantation for primary vesicoureteral reflux: A systematic review and meta-analysis
title_full Extravesical vs. intravesical ureteric reimplantation for primary vesicoureteral reflux: A systematic review and meta-analysis
title_fullStr Extravesical vs. intravesical ureteric reimplantation for primary vesicoureteral reflux: A systematic review and meta-analysis
title_full_unstemmed Extravesical vs. intravesical ureteric reimplantation for primary vesicoureteral reflux: A systematic review and meta-analysis
title_short Extravesical vs. intravesical ureteric reimplantation for primary vesicoureteral reflux: A systematic review and meta-analysis
title_sort extravesical vs. intravesical ureteric reimplantation for primary vesicoureteral reflux: a systematic review and meta-analysis
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9633941/
https://www.ncbi.nlm.nih.gov/pubmed/36340705
http://dx.doi.org/10.3389/fped.2022.935082
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