Prevalence of Bladder and Bowel Dysfunction in Toilet-Trained Children With Urinary Tract Infection and/or Primary Vesicoureteral Reflux: A Systematic Review and Meta-Analysis

Meena, Jitendra; Mathew, Georgie; Hari, Pankaj; Sinha, Aditi; Bagga, Arvind

doi:10.3389/fped.2020.00084

Cited by 28 publications

(9 citation statements)

References 56 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…More emphasis is now placed on an individualized, risk-based approach, with less reliance on long-term antibiotic prophylaxis, reduced use of VCUG and a decline in surgical intervention ( 45 ). Also, patients with concurrent VUR and BBD are understood to have an increased risk of UTI vs. patients with VUR only, meaning that treatments for both conditions may be needed ( 22 , 25 ). It remains unclear whether BBD should always be treated before VUR.…”

Section: Management Recommendationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…VUR and BBD are closely related and around half of patients with VUR also have BBD ( 25 ). Among patients with VUR, additional presence of BBD approximately doubles the risk of UTIs ( 11 , 25 , 26 ). As mentioned above, co-existent BBD may also reduce the likelihood of spontaneous resolution of VUR, and BBD has been associated with reduced success in patients undergoing endoscopic injection for VUR ( 17 , 27 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Management of Vesicoureteral Reflux: What Have We Learned Over the Last 20 Years?

et al. 2021

View full text Add to dashboard Cite

Vesicoureteral reflux (VUR) is associated with increased risks of urinary tract infection, renal scarring and reflux nephropathy. We review advancements over the last two decades in our understanding and management of VUR. Over time, the condition may resolve spontaneously but it can persist for many years and bladder/bowel dysfunction is often involved. Some factors that increase the likelihood of persistence (e.g., high grade) also increase the risk of renal scarring. Voiding cystourethrography (VCUG) is generally considered the definitive method for diagnosing VUR, and helpful in determining the need for treatment. However, this procedure causes distress and radiation exposure. Therefore, strategies to reduce clinicians' reliance upon VCUG (e.g., after a VUR treatment procedure) have been developed. There are several options for managing patients with VUR. Observation is suitable only for patients at low risk of renal injury. Antibiotic prophylaxis can reduce the incidence of UTIs, but drawbacks such as antibiotic resistance and incomplete adherence mean that this option is not viable for long-term use. Long-term studies of endoscopic injection have helped us understand factors influencing use and the effectiveness of this procedure. Ureteral reimplantation is still performed commonly, and robot-assisted laparoscopic methods are gaining popularity. Over the last 20 years, there has been a shift toward more conservative management of VUR with an individualized, risk-based approach. For continued treatment improvement, better identification of children at risk of renal scarring, robust evidence regarding the available interventions, and an improved VUR grading system are needed.

show abstract

Section: Management Recommendationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Management of Vesicoureteral Reflux: What Have We Learned Over the Last 20 Years?

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Diese Problematik wird bei Stuhlentleerungsstörungen, meist einer Obstipation, verstärkt. Gemäss einer Metanalyse aus dem Jahre 2020 zeigt sich, dass ungefähr die Hälfte aller Patienten mit VUR auch eine BBD haben [15]. Bei diesen Patienten verdoppelt sich das Risiko für Harnwegsinfektionen [15,16].…”

Section: Bladder Bowel Dysfunction (Bbd) Und Refluxunclassified

Vesikoureteraler Reflux beim Kind – eine Übersicht

2021

View full text Add to dashboard Cite

ZusammenfassungDer vesikoureterale Reflux (VUR) beschreibt einen nichtphysiologischen Reflux der Harnblase in die Nieren. Während beim primären Reflux und jüngeren Kindern eine hohe Spontanheilungsrate besteht, ist diese beim sekundären Reflux deutlich geringer. Der VUR ist häufig mit einer „bladder bowel dysfunction“ assoziiert, die primär behandelt werden sollte. Hauptkomplikation ist die Refluxnephropathie mit Bildung von Nierennarben und nachfolgend möglicher Einschränkung der Nierenfunktion. Die Therapiemöglichkeiten reichen, abhängig von der klinischen Präsentation und den bestehenden Risikofaktoren, von abwartendem Verhalten bis zur offenen Chirurgie. Ein leichtgradiger VUR (Grad I–II) muss heute nicht mehr behandelt werden. Bei hochgradigem VUR und wiederholten Durchbruchsinfektionen ist die Indikation zur subureteralen Unterspritzung oder zur Ureterneuimplantation gegeben.

show abstract

“…A systemic review found that the presence of both bladder bowel dysfunction (BBD) and VUR doubles the risk of recurrence of UTI; hence, all children presenting with UTI should be carefully evaluated for presence of BBD and managed accordingly [7]. As BBD is an important risk factor for UTI recurrence in future, intervention trials for patients with primary VUR should be stratified as per presence of BBD.…”

mentioning

confidence: 99%

Imaging in Febrile Urinary Tract Infections – Area of Debate

Mehta

2020

Indian J Pediatr

View full text Add to dashboard Cite

Prevalence of Bladder and Bowel Dysfunction in Toilet-Trained Children With Urinary Tract Infection and/or Primary Vesicoureteral Reflux: A Systematic Review and Meta-Analysis

Cited by 28 publications

References 56 publications

Management of Vesicoureteral Reflux: What Have We Learned Over the Last 20 Years?

Management of Vesicoureteral Reflux: What Have We Learned Over the Last 20 Years?

Vesikoureteraler Reflux beim Kind – eine Übersicht

Imaging in Febrile Urinary Tract Infections – Area of Debate

Contact Info

Product

Resources

About