Supplementary Material for: Critical Analysis of a Series of Early Inguinal Ureterostomies: Are They Useful and How Well Are They Tolerated

<b><i>Introduction:</i></b> The study aimed to evaluate the advantages of temporary inguinal ureterostomy in the management of neonates with uropathies and early or recurrent pyelonephritis. <b><i>Patients and Methods:</i></b> We performed a retrospective analysis of all patients who underwent ureterostomies between 1989 and 2012, with specific regards to indications and outcomes. We also performed a survey of parents to evaluate their acceptance of diversion. <b><i>Results:</i></b> We included 18 patients (12 primary high-grade vesicoureteral reflux [VUR] and 6 primary obstructive megaureters [MUs]). Indications were recurrent febrile urinary tract infections (UTIs) despite antibiotic prophylaxis, doubtful function of the overlying kidney for the oldest cases, when renal function was only assessed by intravenous urography, or both. Cutaneous diversion was performed between the ages of 2 weeks to 5 months (median: 1.8 months). Renal function was assessed prior to undiversion to choose between reimplantation and nephrectomy. The incidence of febrile UTIs significantly decreased during the period of diversion. Urinary diversion was judged socially acceptable by parents. Ureterostomy did not modify the overlying kidney function. <b><i>Conclusion:</i></b> Temporary inguinal ureterostomy does not enable better evaluation of renal function by suppressing the pressure of an obstacle or refluxing urines. Its remaining indication seems to be the prevention of recurrent UTIs in neonates and infants with VUR or MU, pending reimplantation.

<b><i>引言：</i></b> 本研究旨在评估暂时性腹股沟输尿管造口术在治疗伴有尿路病变及早期或复发性肾盂肾炎的新生儿中的应用优势。<b><i>患者与方法：</i></b> 本研究对1989年至2012年间接受输尿管造口术的所有患者开展回顾性分析，重点聚焦手术指征与治疗结局；同时通过问卷调查家长对尿液转流术的接受程度。<b><i>结果：</i></b> 本研究共纳入18例患者，其中12例为原发性高级别膀胱输尿管反流（vesicoureteral reflux, VUR），6例为原发性梗阻性巨输尿管症（megaureters, MUs）。手术指征包括：经抗生素预防治疗后仍反复出现发热性尿路感染（urinary tract infections, UTI）；对于月龄较大的病例，若仅通过静脉尿路造影评估患侧肾脏功能存疑，或同时存在上述两种情况。手术于患儿出生后2周至5个月间实施，中位年龄为1.8个月。在撤销尿液转流前，需评估肾脏功能，以抉择实施输尿管再植术或肾切除术。转流期间，发热性尿路感染的发生率显著降低。家长普遍认为该皮肤造口转流术在社会层面可接受。输尿管造口术未对患侧肾脏功能产生不良影响。<b><i>结论：</i></b> 暂时性腹股沟输尿管造口术并不能通过解除梗阻压力或反流尿液来更精准地评估肾脏功能。其剩余适用指征似乎为：在等待输尿管再植术期间，预防伴有膀胱输尿管反流或梗阻性巨输尿管症的新生儿及婴幼儿复发性尿路感染。