Cross-cultural adaptation of the dysfunctional voiding score symptom (DVSS) questionnaire for Brazilian children.

PURPOSE: To translate and culturally adapt the Dysfunctional Voiding Symptom Score (DVSS), questionnaire into Brazilian Portuguese. MATERIALS AND METHODS: The 10-item Dysfunctional Voiding Symptom Score (DVSS) was translated into Brazilian Portuguese according to a standard methodology: translation, synthesis, back-translation, Expert Committee, and pre-testing. After the translation process the final version was pre-tested and patient responses were analyzed to identify necessary modifications. Reliability was evaluated using the test-retest method, and internal consistency was assessed using Cronbach's alpha. RESULTS: The Cronbach's alpha coefficient was calculated in the test and retest phases. Internal consistency was found to be satisfactory, as confirmed by a Cronbach's alpha coefficient of 0.76 for the test and 0.77 for the retest. A high degree of stability was found in the test/retest, with an intraclass correlation coefficient (ICC) of 0.960 (p < 0.001; 95% CI: 0.943-0.972). CONCLUSIONS: The cross-cultural adaptation process of the Dysfunctional Voiding Symptom Score questionnaire to be used on Brazilian children was successfully completed following internationally accepted methodologies.

The role of refluxing distal ureteral stumps after nephrectomy.

BACKGROUND/PURPOSE: Classically, the refluxing distal ureteral stump has been removed during the nephrectomy by the means of an incision on the flank and lower abdominal wall. There are little data in the literature about the natural history of these stumps. In the current work the authors evaluated possible complications affecting the ureteral stump after total or partial nephrectomy for vesicoureteral reflux. METHODS: Between June 1974 and May 1991, our institution performed 25 nephrectomies followed by partial ureterectomy to correct vesicoureteral reflux into a nonfunctional kidney. The authors performed, respectively, 16 total and 9 partial nephrectomies. The reflux to operated units was graded according to the International Grading System as grade 1 (n = 1), grade 2 (n = 4), grade 3 (n = 9), grade 4 (n = 8), and grade 5 (n = 1). RESULTS: Ureteral stump removal was performed in 3 patients (13%). No correlation between the need for ureteral stump removal and age, gender, grade of preoperative reflux, associated contralateral reflux, and ureteral histology, became apparent. CONCLUSION: The remainder of the ureteral stump, after a total or partial nephrectomy to correct vesicoureteral reflux, presents a low rate of complications even in the presence of a high grade of reflux.