Predictive value of clinical factors for successful endoscopic correction of primary vesicoureteral reflux grades III–IV

Méndez, Roberto; Argibay, Iván Somoza; Tellado, M; Liras, Jorge; Sánchez, Alberto; Pais, Ernesto; Vela, Diego

doi:10.1016/j.jpurol.2005.11.012

Cited by 18 publications

(12 citation statements)

References 19 publications

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“…More interestingly from the clinical point of view, high PVR at baseline also merged as a predictor of recurrent UTI and renal damage at the one-year follow-up. The correlation between LUTD and a lower probability of VUR resolution has previously been shown [21,[116][117][118][119] and also that increased PVR correlates with recurrent UTI in infants with hVUR [37,120].…”

Section: Bladder Functionmentioning

confidence: 83%

The Swedish infant high-grade reflux trial: Study presentation and vesicoureteral reflux outcome

Nordenström

Holmdahl

Brandström

et al. 2016

Journal of Pediatric Urology

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Section: Bladder Functionmentioning

confidence: 83%

The Swedish infant high-grade reflux trial: Study presentation and vesicoureteral reflux outcome

Nordenström

Holmdahl

Brandström

et al. 2016

Journal of Pediatric Urology

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“…Few studies have been carried out about distal ureteral dilatation as a factor influencing the spontaneous resolution of primary VUR. Méndez et al classified patients into three groups according to how much the lower ureter was dilated on ultrasonography and analyzed the prognoses after ureteral submucosal injection [5]. They reported that distal ureteral dilatation was an important prognostic factor in treating primary reflux.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the existing prognostic factors and reflux grades, other factors have recently been reported [5,6]. In particular, we have focused on the recent literature that VUR is influenced by the severity of distal ureteral dilatation and analyzed the degree with which distal ureteral dilatation influenced the spontaneous resolution of VUR to ascertain whether ureteral dilatation is as valuable a prognostic factor as the ones currently in existence.…”

Section: Introductionmentioning

confidence: 99%

The Value of Estimation of Distal Ureteral Dilatation in Primary Vesicoureteral Reflux

Kang

Kim

et al. 2010

Korean J Urol

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PurposeRecently, several studies have suggested that distal ureteral dilatation is an important factor influencing the spontaneous resolution of primary vesicoureteral reflux (VUR). We evaluated the relationship between distal ureteral dilatation and the spontaneous resolution of primary VUR.Materials and MethodsThe medical records of 114 patients with primary VUR maintained on prophylactic antibiotics from April 1999 to August 2008 were retrospectively reviewed. The patients' mean age was 24.2 months (range, 6-108 months). There were 66 male patients and 48 female patients. The mean follow-up was 37.6 months (range, 12-102 months). We analyzed various factors including age, gender, grade of reflux, laterality, and ureteral diameter ratio (UDR; the largest ureteral diameter was divided by the distance from the L1-4 vertebral body to minimize the differences in diameter by age) to determine whether these factors influenced the spontaneous resolution of primary VUR.ResultsUnilateral, low-grade reflux and low UDR were significantly associated with the spontaneous resolution of reflux (p=0.048, p<0.001, and p<0.001, respectively). The multivariate analysis revealed that the spontaneous resolution rate of primary reflux was significantly higher in patients with low UDR than in patients with high UDR (p<0.001).ConclusionsThe degree of distal ureteral dilatation is expected to be another important factor in determining therapeutic course and predicting the spontaneous resolution of VUR.

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“…Dysfunctional voiding can also be observed in kidney transplant patients, which is frequently reflected in the form of a nycturia, and, with an occurrence rate of 60%, can be considered as being frequent. In addition to the danger of a secondary VUR through the increased intravesical pressure, bladder dysfunction represents a risk of impairment to transplant function and appears to influence negatively the success rate of endoscopic therapy [22,23].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic application of dextranomer/hyaluronic acid copolymer in the treatment of vesico‐ureteric reflux after renal transplantation

et al. 2010

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Study Type – Therapy (case series) Level of Evidence 4 What’s known on the subject? and What does the study add? Vesicoureteral reflux (VUR) after renal transplantation may cause recurrent urinary tract infections (UTIs) and loss of renal function with consecutive risk of progressive graft damage. There are only a few series on the therapeutic success of dextranomer/hyaluronic acid copolymer treatment by transurethral injection. We assessed whether transurethral endoscopic therapy is an alternative strategy treating VUR in this special patient collective and we found out that this surgical method is a minimally invasive and efficient procedure with reflux resolution rate of approximately 60% after one and 79% after two injections with significant reduction of postoperative UTIs on short‐term follow up. OBJECTIVE • To evaluate the success of endoscopic dextranomer/hyaluronic acid copolymer (DHAC) application in the treatment of patients with recurrent urinary tract infections (UTIs) and vesico‐ureteric reflux (VUR) into the transplanted graft after renal transplantation. PATIENTS AND METHODS • Between January 2008 and April 2009, 19 patients with recurrent UTIs presented VUR proven by voiding cystourethrography. • To correct VUR of the transplanted ureter, DHAC was injected endoscopically using hydrodistention technique. • Pre‐ and postoperative serum creatinine levels, the number of pre‐ and postoperative UTIs, postoperative complications and reflux resolution rate were recorded. The mean follow‐up was 6.5 months. RESULTS • The average number of UTIs was reduced significantly from 4.89 (range 2–14) to 1.31 (range 0–4) on pre‐ and postoperative follow‐up, respectively, of 6 months (P < 0.001). The success rate increased from 57.9% after the first injection to 78.9% after the second injection. • The remaining four patients with residual VUR received long‐term low dose antibiotic prophylaxis. In total, two (10.5%) patients developed increasing creatinine levels postoperatively as a result of distal ureteral obstruction, and temporary urinary drainage was necessary in both patients. CONCLUSIONS • DHAC appears to be an efficient and minimal invasive method for treating VUR after renal transplantation with respect to short‐term success. • Further investigation with a larger group of patients and longer follow‐up is needed to evaluate the prolonged effect, as well as any potential side effects.

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Predictive value of clinical factors for successful endoscopic correction of primary vesicoureteral reflux grades III–IV

Cited by 18 publications

References 19 publications

The Swedish infant high-grade reflux trial: Study presentation and vesicoureteral reflux outcome

The Swedish infant high-grade reflux trial: Study presentation and vesicoureteral reflux outcome

The Value of Estimation of Distal Ureteral Dilatation in Primary Vesicoureteral Reflux

Endoscopic application of dextranomer/hyaluronic acid copolymer in the treatment of vesico‐ureteric reflux after renal transplantation

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