Contemporary Management of Vesicoureteral Reflux

Johnston, Derrick; Qureshi, Aslam; Irvine, Rhys W; Giel, Dana W.

doi:10.1007/s40746-016-0045-9

Cited by 13 publications

(14 citation statements)

References 51 publications

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“…Several bulking agents have been used over the past two decades in the treatment of VUR. In 2001, the US Food and Drug Administration (FDA) approved the use of dextranomer/hyaluronic acid as the first FDA-approved subepithelial injectable treatment for VUR in the USA [10].…”

Section: Discussionmentioning

confidence: 99%

Bilateral duplex collecting system with bilateral vesicoureteral reflux: a case report

Yonli

Chakroun²,

Zaghbib³

et al. 2019

J Med Case Reports

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Background A bilateral duplex collecting system is an unusual renal tract abnormality. Vesicoureteral reflux may be associated. We describe a rare case of bilateral duplex collecting system with bilateral vesicoureteral reflux in which the refluxing ureter on the left side drains the upper pole moiety contrary to what is often found. Case presentation A 24-year-old married Arab woman presented with ascending left-sided flank pain during micturition. She complained of recurrent urinary tract infections. A physical examination and laboratory tests were normal. Voiding cystourethrography and computed tomography scan detected bilateral duplex collecting system, grade IV vesicoureteral reflux on the left side, and grade I vesicoureteral reflux on the right. She underwent left heminephrectomy and dextranomer/hyaluronic acid injections on the right side. After a year of follow-up, a clinical examination and imaging findings were unremarkable. Conclusions A bilateral duplex collecting system with refluxing upper pole moiety ureter is a very rare entity. The diagnosis should be suspected when exploring any flank pain with recurrent urinary tract infections to avoid subsequent renal impairment. Furthermore, this case shows how some common symptoms may lead to finding an unexpected urinary tract abnormality.

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Section: Discussionmentioning

confidence: 99%

Bilateral duplex collecting system with bilateral vesicoureteral reflux: a case report

Yonli

Chakroun²,

Zaghbib³

et al. 2019

J Med Case Reports

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“…Regardless of the substance injected, the endoscopic approach to reflux management is improving, giving better results by time and has gained favor over the past several years over the other treatment options in both Europe (22)(23)(24) and the United States (25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

Efficiency of endoscopic treatment compared to open surgical management of the vesicoureteral reflux

Mugabe¹,

Kojović²

2018

Medicinski podmladak

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Introduction: Vesicoureteral reflux (VUR) represents the retrograde flow of urine from the bladder to the upper urinary tract. It can be managed by continuous antibiotic prophylaxis of the urinary tract infections until spontaneous resolution occurs, surgical ureteral reimplantation (ureteroneocystostomy), or endoscopic treatment by injecting bulking agents. The aim: To assess the efficacy of the endoscopic treatment of VUR in comparison to the ureteroneocystostomy. Material and methods: The first group included 300 children with VUR, II to IV grades managed by endoscopic injection from 2005 to 2015, and second group included 300 patients who underwent surgical treatment for the IV or V grade of VUR from 1997 until 2009. The results of treatment and complication rate were analysed and compared. We did the same analysis considering the total number of ureteral units. Results: Of total of 300 patients treated endoscopically, in 281 (93.67%) patients the reflux was completely resolved; in 10 (3.33%), the reflux was downgraded (decreased for one or two grades) and in 9 (3%) the intervention was unsuccessful. In 430 ureteral units, full resolution was achieved in 402 (93.49%) units; in 10 (2.33%), the reflux was downgraded and in 18 (4.65%) the reflux didn't resolve. In 300 patients who underwent open surgery, in 290 (96.7%) the reflux was resolved; in 8 (2.67%), the reflux was downgraded from the V/IV to the grades I to III; in 2 (0.66%) the operation was unsuccessful. Out of 480 ureteral units, in 463 (96.46%) units the reflux was resolved; in 13 (2.71%), the grade of reflux was reduced, while in 4 (0.83%) units the reflux was persistent. Recorded success rate didn't show any statistically significant difference between these two groups. The length of hospital stay was significantly shorter and the number of complications was lower in the group of patients treated by endoscopic injection. Conclusion: Comparable success rate, shorter hospital stay, and fewer complications make the endoscopic treatment more preferable option.

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“…Current evidence suggests that CAP reduces the rate of recurrence of UTI until the reflux resolves. The majority of lower-grade VURs spontaneously resolve as the child grows [26]. Roussey-Kessler et al performed a randomized controlled trial (RCT) of 225 children in which children from ages one month to three years with grade I-III VUR were assigned randomly, to receive daily cotrimoxazole or no treatment and followed up for 18 months [27].…”

Section: Vur and Antibiotic Prophylaxismentioning

confidence: 99%

“…Another significant drawback to CAP is antibiotic resistance. The RIVUR trial demonstrated a substantial amount of resistance to TMP/SMX in patients on prophylaxis with breakthrough UTI compared to the patients on placebo [26].…”

Section: Risks Of Prophylactic Antibioticsmentioning

confidence: 99%

Role of Antibiotic Prophylaxis in the Management of Antenatal Hydronephrosis, Vesicoureteral Reflux, and Ureterocele in Infants

Zaveri

Perry

Schuetz

et al. 2020

Cureus

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Widespread prenatal screening has resulted in increased detection of anomalies of the kidneys and urinary tract. Antenatal hydronephrosis (AHN) and vesicoureteral reflux (VUR) are among the most common congenital anomalies diagnosed in utero or after birth. Pediatric urologists frequently rely on continuous antibiotic prophylaxis (CAP) for managing AHN, VUR, and ureterocele, unless definitive treatment is performed. The main aim of antibiotic prophylaxis (ABP) is to prevent urinary tract infection and long-term complications. Nevertheless, the efficacy of ABP has been a source of considerable debate, and pediatricians have varied opinions on who would benefit from ABP. In this review article, we searched the currently available literature, for evidence of the role of ABP in the setting of AHN, VUR, and ureterocele. Most of our studies showed a limited benefit of ABP for HN and VUR. The data on the use of CAP in the management of ureterocele is scarce. However, due to the involvement of independent risk factors and other variables, a conclusion cannot be drawn from these studies alone. Pediatric urologists are urged to conduct randomized controlled trials to compare patients followed up with and without ABP. Given the lack of guidelines, an individualized approach should be used for the use of ABP, until precise guidelines and recommendations are developed.

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Contemporary Management of Vesicoureteral Reflux

Cited by 13 publications

References 51 publications

Bilateral duplex collecting system with bilateral vesicoureteral reflux: a case report

Bilateral duplex collecting system with bilateral vesicoureteral reflux: a case report

Efficiency of endoscopic treatment compared to open surgical management of the vesicoureteral reflux

Role of Antibiotic Prophylaxis in the Management of Antenatal Hydronephrosis, Vesicoureteral Reflux, and Ureterocele in Infants

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