We read with great interest the article by Kawal et al. [
[1]
] evaluating the risk factors for postoperative urinary retention after robot-assisted
laparoscopic extravesical ureteral reimplantation (RALUR) in pediatric patients in
a recent issue of the journal. As mentioned by the authors, retention is a potential
complication reported after open extravesical reimplantation and RALUR at a rate of
3–22% and 2–10%, respectively. The incidence can reach up to 4–37%, especially in
bilateral cases [
[2]
]. Surgical technique is one of the main reasons for retention, and it has been attributed
to the neuropraxia of autonomic nerve fibers around the ureteral hiatus or direct
nerve damage [
- Song S.H.
- Kim I.A.
- Han J.H.
- Kim K.S.
- Kim E.J.
- Sheth K.
- et al.
Preoperative bladder bowel dysfunction is the most important predictive factor for
postoperative urinary retention after robot-assisted laparoscopic ureteral reimplantation
via an extravesical approach: a multi-center study.
J Endourol. 2021; 35: 226-233
[2]
]. Although the other most common known risk factor for retention was reported as
bilaterality [
- Song S.H.
- Kim I.A.
- Han J.H.
- Kim K.S.
- Kim E.J.
- Sheth K.
- et al.
Preoperative bladder bowel dysfunction is the most important predictive factor for
postoperative urinary retention after robot-assisted laparoscopic ureteral reimplantation
via an extravesical approach: a multi-center study.
J Endourol. 2021; 35: 226-233
[3]
], only male gender and length of surgical time were found to be predictive by Kawal
et al. [
[1]
]. Contrary, high grade reflux, younger age (<3 years) and a history of bladder bowel
dysfunction (BBD) have also been reported as other risk factors for retention according
to other studies [
[2]
,
- Song S.H.
- Kim I.A.
- Han J.H.
- Kim K.S.
- Kim E.J.
- Sheth K.
- et al.
Preoperative bladder bowel dysfunction is the most important predictive factor for
postoperative urinary retention after robot-assisted laparoscopic ureteral reimplantation
via an extravesical approach: a multi-center study.
J Endourol. 2021; 35: 226-233
[4]
].- Esposito C.
- Varlet F.
- Riquelme M.A.
- Fourcade L.
- Valla J.S.
- Ballouhey Q.
Postoperative bladder dysfunction and outcomes after minimally invasive extravesical
ureteric reimplantation in children using a laparoscopic and a robot-assisted approach:
results of a multicentre international survey.
BJU Int. 2019; 124: 820-827
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References
- Robotic-assisted laparoscopic ureteral re-implant (RALUR): can post-operative urinary retention be predicted?.J Pediatr Urol. 2018; 14 (323 e321-5)
- Preoperative bladder bowel dysfunction is the most important predictive factor for postoperative urinary retention after robot-assisted laparoscopic ureteral reimplantation via an extravesical approach: a multi-center study.J Endourol. 2021; 35: 226-233
- Is robot-assisted laparoscopic bilateral extravesical ureteral reimplantation associated with greater morbidity than unilateral surgery? A comparative analysis.J Pediatr Urol. 2017; 13 (494 e491-7)
- Postoperative bladder dysfunction and outcomes after minimally invasive extravesical ureteric reimplantation in children using a laparoscopic and a robot-assisted approach: results of a multicentre international survey.BJU Int. 2019; 124: 820-827
- Additional VCUG-related parameters for predicting the success of endoscopic injection in children with primary vesicoureteral reflux.J Pediatr Urol. 2021; 17 (68.e1-8)
Article info
Publication history
Published online: April 26, 2021
Accepted:
March 23,
2021
Received:
March 19,
2021
Identification
Copyright
© 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Robotic-assisted laparoscopic ureteral re-implant (RALUR): Can post-operative urinary retention be predicted?Journal of Pediatric UrologyVol. 14Issue 4
- PreviewUrinary retention following robotic-assisted laparoscopic extravesical ureteral reimplantation (RALUR) is proposed to be due to traction or injury of the pelvic parasympathetic nerve plexus during distal ureteral dissection. Nerve-sparing techniques have been employed to avoid injury to the pelvic plexus, either directly or indirectly. This single-center study assessed postoperative urinary retention rates after extravesical RALUR and investigated whether demographic or operative factors could predict this occurrence.
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