Our Summary

The study looks at the effectiveness and safety of two surgical methods used to treat a condition in children called vesicoureteral reflux (VUR), where urine flows backward from the bladder to the kidneys. The two methods compared were robot-assisted laparoscopic ureteral reimplantation (RALUR), a minimally invasive surgery using a robot, and open ureteral reimplantation (OUR), a traditional open surgery.

The researchers found articles and studies on this topic from several databases and included six studies with 7122 children in their analysis. They found that the robot-assisted surgery took longer than the traditional one, but children who had the robot-assisted surgery had a shorter hospital stay and less time with a catheter after surgery.

There were no major differences between the two methods in terms of blood loss during surgery, success rate of the surgery, complications, and use of pain medication after surgery. However, there was a higher rate of short-term complications after surgery with the robot-assisted method.

In conclusion, while the robot-assisted method is effective and allows patients to leave the hospital sooner, there might be a higher risk of short-term complications after surgery. So, doctors should be cautious when considering this method.

FAQs

  1. What is vesicoureteral reflux (VUR) and how is it treated in children?
  2. What are the differences in outcomes between robot-assisted laparoscopic ureteral reimplantation and open ureteral reimplantation?
  3. Is there a higher risk of complications with the robot-assisted method of ureteral reimplantation?

Doctor’s Tip

A helpful tip a doctor might tell a patient about ureteral reimplantation is to carefully weigh the benefits and potential risks of both robot-assisted laparoscopic ureteral reimplantation and open ureteral reimplantation before making a decision. It’s important to discuss these options with your healthcare provider to determine the best approach for your individual situation. Additionally, make sure to follow all post-operative instructions provided by your doctor to promote a successful recovery.

Suitable For

Patients who are typically recommended ureteral reimplantation are those with vesicoureteral reflux (VUR), a condition where urine flows backward from the bladder to the kidneys. This condition is more common in children, and ureteral reimplantation is often recommended for those with severe or recurrent VUR that has not responded to other treatments. The study specifically looked at children with VUR who required surgical intervention to treat their condition.

Timeline

Before ureteral reimplantation, a patient may experience symptoms of vesicoureteral reflux such as urinary tract infections, frequent urination, painful urination, and incontinence. They may undergo diagnostic tests such as ultrasound, voiding cystourethrogram, and renal scans to confirm the diagnosis.

After ureteral reimplantation, the patient will be monitored closely in the hospital for a few days for any complications. They may experience pain and discomfort at the surgical site and will be given pain medication as needed. The patient will also have a catheter in place for a period of time to help drain the bladder.

In the weeks following surgery, the patient will have follow-up appointments with their healthcare provider to monitor their recovery and ensure the surgery was successful. They may need to take antibiotics to prevent infection and will gradually return to their normal activities as advised by their healthcare provider. Overall, the goal of ureteral reimplantation is to correct the vesicoureteral reflux and improve the patient’s quality of life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about ureteral reimplantation include:

  1. What is the reason for recommending ureteral reimplantation in my case?
  2. What are the potential risks and benefits of robot-assisted laparoscopic ureteral reimplantation compared to open ureteral reimplantation?
  3. How experienced are you with performing robot-assisted laparoscopic ureteral reimplantation?
  4. What is the expected recovery time and follow-up care after the surgery?
  5. What are the potential short-term and long-term complications of ureteral reimplantation?
  6. Will I need to take any medication or make lifestyle changes after the surgery?
  7. How will the success of the surgery be monitored and evaluated?
  8. Are there any alternative treatment options for my condition?
  9. How can I best prepare for the surgery and what should I expect during the recovery process?
  10. Are there any specific factors in my case that may make one surgical method more suitable for me than the other?

Reference

Authors: Deng T, Liu B, Luo L, Duan X, Cai C, Zhao Z, Zhu W, Wu W, Zeng G. Journal: World J Urol. 2018 May;36(5):819-828. doi: 10.1007/s00345-018-2194-x. Epub 2018 Jan 27. PMID: 29374841