Giggle incontinence: a scoping review.

Giggle incontinence (GI) is poorly described, defined, and understood. It is considered a bladder storage disorder in which laughter causes an uncontrollable episode of urinary incontinence that cannot be stopped until the bladder is completely emptied. It has been confused with stress urinary incontinence and overactive bladder. A thorough analysis of 26 articles on the subject of "giggle incontinence" and associated terms was performed, including all articles since the phrase first appeared. To date, 351 GI cases have been reported. It occurs mainly in women (69.5%) at 5 years of age, with a prevalence ranging from 8.4 to 16.2 years (average age of 12.4 years), and some cases have a family history of the disease (13-16.7%). This review discusses the historical background, current understanding, and challenges related to GI. It primarily affects females after the age of 5 years, causing complete bladder emptying during uncontrollable laughter. The exact cause is unknown, but hypotheses suggest involvement of the central nervous system. Diagnosis relies on clinical history, physical tests, and urine frequency evaluation. Management involves urotherapy techniques, biofeedback, and methylphenidate. Understanding GI will aid in developing more effective management techniques. IMPACT: Highlights limited awareness among healthcare professionals about giggle incontinence as a distinct condition, emphasizing the need for standardized diagnostic criteria and assessment tools. Addresses insufficient understanding of the underlying mechanisms and contributing factors, providing valuable insights for better diagnosis and treatment. Emphasizes the importance of patient education and support, calling for improved resources and counseling. Urges further research and evidence-based guidelines to enhance treatment strategies.

Influence of constipation on enuresis.

INTRODUCTION: Constipation has classically been considered as a risk factor of enuresis, although there are increasingly more publications that report a similar prevalence of constipation in both enuretics and non-enuretics. OBJECTIVE: To determine the influence of constipation in monosymptomatic and non-monosymptomatic enuresis, and to find out the prevalence of the three disorders, as well as the lower urinary tract dysfunction and bladder-bowel dysfunction in the population. MATERIAL AND METHOD: A cross-sectional observational prevalence study on a representative population sample of 5-9 year-old school boys and girls of Galicia, Spain. A questionnaire was completed in the schools on urinary and bowel habits, which included questions from the Paediatric Lower Urinary Tract Scoring System (PLUTSS) diagnostic questionnaire and grading of the lower urinary tract dysfunctions. The enuresis was diagnosed using the International Children's Continence Society (ICSS), and if it was also associated with diurnal symptoms, it was also classified as non-monosymptomatic enuresis. The constipation was evaluated using the Rome III criteria and the adapted Bristol stool scale. RESULTS: A total of 772 questionnaires were included in the study. The prevalence of constipation was 20% and that of enuresis was 9.1% (62.9% monosymptomatic enuresis and 37.1% non-monosymptomatic), with the prevalence of bladder-bowel dysfunction being 5.2%. It was observed that constipation had no influence on the presence of monosymptomatic enuresis, but it did have an influence on non-monosymptomatic enuresis and lower urinary tract dysfunctions, where it was a significant risk factor. CONCLUSIONS: The differential diagnosis between monosymptomatic and non-monosymptomatic enuresis is essential in the initial evaluation of the patient with enuresis, since the therapeutic management and the characteristics of both disorders are different, with constipation only being a risk factor in cases of non-monosymptomatic enuresis.

Influencia del estreñimiento en la enuresis monosintomática y en el síndrome enurético / Influence of constipation on monosymptomatic enuresis and in enuretic syndrome

Introducción: Clásicamente se ha considerado el estreñimiento como un factor de riesgo de la enuresis, aunque cada vez hay más publicaciones que reportan una prevalencia de estreñimiento similar en enuréticos y no enuréticos. Objetivo: Determinar la influencia del estreñimiento en la enuresis monosintomática y la no monosintomática y conocer la prevalencia de las 3 entidades así como de disfunciones del trato urinario inferior y disfunción vesicointestinal en la población. Material y método: Estudio observacional transversal de prevalencia sobre una muestra representativa de la población gallega de niños y niñas escolarizados de 5 a 9años. Se realizó una encuesta en los colegios sobre hábitos miccionales e intestinales que incluía las preguntas del cuestionario Paediatric Lower Urinary Tract Scoring System (PLUTSS) de diagnóstico y graduación de las disfunciones del tracto urinario inferior. Se consideró la enuresis según los criterios de la Sociedad Internacional para la Continencia en Niños (ICSS), y si además asociaba sintomatología diurna, se clasificó como enuresis no monosintomática. El estreñimiento se valoró de acuerdo con los criterios Roma III y la escala de heces de Bristol adaptados. Resultados: Se incluyeron 772 encuestas en el estudio. La prevalencia de estreñimiento fue del 20%, la de enuresis del 9,1% (enuresis monosintomática 62,9% y no monosintomática 37,1%) y la de disfunción vesicointestinal del 5,2%. Observamos que el estreñimiento no influye en la presencia de enuresis monosintomática, pero sí en la enuresis no monosintomática y las disfunciones del trato urinario inferior, donde constituye un importante factor de riesgo. (AU)

Introduction: Constipation has classically been considered as a risk factor of enuresis, although there are increasingly more publications that report a similar prevalence of constipation in both enuretics and non-enuretics. Objective: To determine the influence of constipation in monosymptomatic and non-monosymptomatic enuresis, and to find out the prevalence of the three disorders, as well the lower urinary tract dysfunction and bladder-bowel dysfunction in the population. Material and method: A cross-sectional observational prevalence study on a representative population sample of 5 to 9 year-old school boys and girls of Galicia, Spain. A questionnaire was completed in the schools on urinary and bowel habits, which included questions from the Paediatric Lower Urinary Tract Scoring System (PLUTSS) diagnostic questionnaire and grading of the lower urinary tract dysfunctions. The enuresis was diagnosed using the International Children's Continence Society (ICSS), and if it was also associated with diurnal symptoms, it was also classified as non-monosymptomatic enuresis. The constipation was evaluated using the Rome III criteria and the adapted Bristol stool scale. Results: A total of 772 questionnaires were included in the study. The prevalence of constipation was 20% and that of enuresis was 9.1% (62.9% monosymptomatic enuresis and 37.1% non-monosymptomatic), with the prevalence of bladder-bowel dysfunction being 5.2%. It was observed that constipation had no influence on the presence of monosymptomatic enuresis, but it did have an influence on non-monosymptomatic enuresis and lower urinary tract dysfunctions, where it was a significant risk factor. (AU)

[Endoscopic treatment of complicated vesicoureteral reflux grades III-V in infants under the age of one year]. / Tratamiento endoscópico del reflujo vesico ureteral III-V complicado en lactantes menores de 1 año.

OBJECTIVES: Our aim is to know the results of Endoscopic Treatment (ET) in infants with recurrent pyelonephritis and high grade (G) Vesicoureteral Reflux (VUR). INCLUSION CRITERIA: infants 2-12 months old with G III-V VUR and at least 2 pyelonephritis, one of them during antibiotic prophylaxis (AP). N = 27 infants: 19 males (70%) and 8 females. VUR was primary in 17 (63%) and secondary in 10. VUR Grade was III in 12 ureters (U) (32%), IV 16 (42%) and V 10 (26%). Polydimethylsiloxane, Hydroxiapatite and Dextranomer/ Hyaluronic Acid (DAH) were the bulking agents employed. Results Classification: Solved: G 0-I.; Improved: G II (control without AP); Persistence: III-V Open Surgery (OS) or repeated ET (1-2) was done depending on cystoscopic findings. RESULTS: 34 ureters are available for final results; 1 G III, 2 G IV and 1 G V are waiting for a new injection. G III 11 U: 11 first and 4 second injections (1.36 Injections / ureter): Solved 9 (81.8%), Improved 1, OS 1 (9%). G IV 14 U: 14 first 3 second and 1 third injection (1.28 injections / ureter): Solved 10 (71.4%), Improved 4. No OS. G V 9 U: 9 first, 4 second and 1 third injections (1.55 injections / ureter): Solved 5 (55.6%), Improved 1, OS 3 (33.3%). Overall results: Solved: 24 U (70.58%), Improved: 6 (17.6%), OS 4 (11.8%). OS avoided 30 (88.2%): G III 91%, IV 100% and V 66.7%. Results of G III are better than G V. The only complication was 1 ureteral obstruction treated successfully with open surgery. CONCLUSIONS: ET can be considered the first therapeutic option in infants with G III-V VUR and pyelonephritis in spite of PA, because ET has solved VUR in 70.58% and avoided OS in 88.2% with a minimally invasive procedure and low incidence of complications.

[Transitory urinary retention after simultaneous bilateral extravesical ureteral reimplantation]. / Retención urinaria transitoria en el reimplante ureteral extravesical bilateral simultáneo.

OBJECTIVES: We report the outcome and incidence of urinary retention after bilateral extravesical reimplant in patients with primary vesicoureteral reflux. METHODS: We retrospectively evaluated the chart of 127 patients, 92 females and 35 males, who underwent correction of primary vesicoureteral reflux using the extravesical approach. Mean patient age at surgery was 3.93 years. Postoperatively the urethral catheter was removed after 24 to 72 hours and a voiding trial was done. Surgical outcomes were analyzed specifically for perioperative complications and resolution of reflux on postoperative VCUG. RESULTS: Mean follow-up was 4.01 years. Postoperative VCUG showed resolution of reflux in 122 (96%) patients. Urinary retention developed in 7/127 patients (5.5%). In 57 patients in whom the surgery was done from 06-1998 to 01-2001, urinary retention developed in 5/57 (8.7%) for 1 day (1), 2 days (1), 5 days (2) and 4 weeks (1). In 70 patients in whom the surgery was done from 02-2001 to 10-2006, urinary retention developed in 2/70 (2.85%) for 1 day (2). CONCLUSIONS: Bilateral extravesical vesicoureteral reimplant can be associated with temporary urinary retention. In the last 5 years, with a careful and limited dissection close to the distal ureter and used of bipolar cautery when necessary, we were able to decreased the risk of postoperative urinary retention.

[Contralateral vesicoureteral reflux after endoscopic treatment of primary unilateral reflux]. / Obstruccion ureteral postoperatoria después de antirreflujo endoscópico.

OBJECTIVES: The endoscopic treatment (ET) of vesicoureteral reflux (VUR) is considered by many urologic and pediatric surgeons as the first treatment option in the event of being required, because it is a minimally invasive procedure, of short duration, ambulatory in many cases, with good results and few complications. Ureteral obstruction is the most serious but less frequent complication. The objective is know the incidence, treatment and evolution of patients with ureteral obstruction as complication of the ET of VUR. METHODS: Evaluation of the medical literature using Pubmed and Ovid. Revision of the clinical report of children (CH) under ET of VUR between March of 1998 and July of 2007, to find those cases that presented ureteral obstruction after ET. RESULTS: A total of 377 children (CH) with VUR in 598 ureters (U), were treated with TE, during the mentioned period of 9 years, between March 1998 and July 2007. Only 2 U (0.33%), in 2 CH (0.5%) presented Ureteral Obstruction with dilatation of the upper urinary tract that need open surgical ureteral reimplantation, with good results in both patients. CONCLUSION: The risk of ureteral obstruction after ET of VUR is low, less than 0.5% of U. The treatment of this complication can be endoscópic or by open surgery both of them with good results.

[Postoperative ureteral obstruction after endoscopic antireflux therapy]. / Reflujo vesicoureteral contralateral despues del tratamiento endoscópico del reflujo unilateral primario.

OBJECTIVES: To know the incidence of new contralateral VUR and its evolution in children with primary unilateral vesicoureteral reflux (VUR) managed with endoscopic treatment (ET). METHODS: During 7.5 years a total of 228 children with primary VUR underwent endoscopic implantation of bulking material, 90 of them (39.5%) have been unilateral. The inclusion criterion was: unilateral primary VUR managed with ET, without previously contralateral VUR. Collected data included: patient age, gender, indications for surgery, number of preoperative cystourethrograms, preoperative and new contralateral postoperative VUR grades, nephropathy in the ipsilateral or contralateral sides, type and volume of bulking material used, and VUR outcome. An update bibliographic review with methanalysis is also performed to compare results. RESULTS: Six children (6.7%) developed new contralateral VUR. Mean age was 3.3 years. Four patients were females and 2 males. The bulking material used was polydimethylsiloxane in one and Dextranomer/Non animal stabilished hyaluronic acid in 5. The initial grades of primary VUR were: II in 1 case, III in 3, and IV in 2. Four patients had previous history of bladder dysfunction. The new contralateral VUR was II in 5 and III in one. In 5 patients initial VUR persisted, always of lower grade than previously, and new contralateral VUR appeared. In one patient initial VUR disappeared and appeared in the contralateral side. Five patients were reinjected and VUR was cured, except one who is waiting for a new endoscopic procedure. One patient with grade II contralateral VUR is under observation. In the metanalysis performed nine issues have been found with an incidence of 8.2%. CONCLUSION: Contralateral VUR is a relatively frequent complication in unilateral primary VUR treated by endoscopic procedures (6.7%), but not enough as to perform bilateral endoscopic treatment in all unilateral VUR. Contralateral VUR etiology is not clear but bladder dysfunction can be an important factor.

Tratamiento endoscópico del reflujo vesico ureteral III y V complicado en lactantes menores de 1 año / Endoscopic treatment of complicated vesicoureteral reflux grades III-V in infants under the age of one year

Objetivo: Conocer los resultados, complicaciones y la evolución de ocho pacientes diagnosticados de Vejiga neurógena (VN), intervenidos de Reflujo vesicoureteral (RVU) mediante la inyección subureteral de sustancias inertes, intentando precisar su indicación en el esquema terapéutico de la alteración vesical neurógena. Métodos: Revisión retrospectiva de los resultados obtenidos y de las complicaciones evidenciadas durante los controles evolutivos efectuados a ocho pacientes en edad pediátrica con VN secundaria a diferentes patologías, diagnosticados de RVU, tratado mediante inyección subureteral de pasta de teflón (1 caso), polidimetilsiloxano (6) y copolímero de dextranómero y ácido hialurónico (1). Resultados: De los 11 uréteres tratados en 8 (72.7%) el RVU curó después de la primera inyección. De los 3 uréteres con persistencia del RVU, en dos cesó después del segundo tratamiento endoscópico (TE). La eficacia del TE después de la segunda inyección alcanzó el 90.9%. En dos casos unilaterales evidenciamos RVU contralateral que curó mediante TE en uno siguiendo pauta conservadora el segundo. Durante el periodo de seguimiento (tiempo medio: 51.8 +/- 28.5 meses) presentaron complicaciones 4 casos. Reapareció el RVU en dos, observamos RVU contralateral en uno a los 19 meses del primer tratamiento y en otro evidenciamos ureterohidronefrosis bilateral con infecciones urinarias recurrentes que precisó de cistoplastia de aumento. Conclusiones: El TE es una opción eficaz cuando se decide el tratamiento quirúrgico del RVU en un paciente con vejiga neurógena. Es necesario seguir la evolución a largo plazo de los pacientes intervenidos, sobre todo aquellos con capacidad y acomodación vesical alterada y uretra activa o disinérgica, ante la posibilidad de aparición del RVU ya curado (AU)

Objectives: To know the results, complications and outcomes of eight patients with the diagnosis of neurogenic bladder (NB) who underwent vesicoureteral reflux surgery by subureteral injection of inert substances, trying to precise its indication in the therapeutic scheme for neurogenic bladder dysfunction. Methods: Retrospective review of the results and complications recorded during follow-up in eight pediatric patients with NB secondary to various pathologies and the diagnosis of VUR treated by subureteral injection of Teflon paste (1 case), polydimethylsiloxane (6) and dextranomer/hyaluronic acid copolymer (1). Results: In 8 (72.7%) of the 11 ureters treated VUR was cured after first injection. VUR stopped after second endoscopic treatment in 2 of the 3 ureters with persistent VUR. The efficacy of endoscopic treatment after second injection achieved 90.9%. In 2 unilateral cases we observed contralateral VUR, which cured in one case after endoscopic treatment and the other one followed a conservative scheme. Over the follow-up period (Mean FU time 51.8+/- 28.5 months) 4 cases presented complications. VUR recurred in two: in one contralateral VUR was detected 19 months after first treatment, the other one presented bilateral ureterohydronephrosis with recurrent urinary tract infections and required augmentation cystoplasty. Conclusions: Endoscopic treatment is an effective option when choosing surgical treatment for VUR in a patient with neurogenic bladder. It is necessary to follow the long-term outcome of patients after surgery, mainly those with abnormal bladder capacity and compliance and active or dyssynergic urethra due to the possibility of recurrence of the VUR (AU)

Retención urinaria transitoria en el reimplante ureteral extravesical bilateral simultáneo / Transitory urynary retention after simultaneous bilateral extravesical ureteral reimplantation

Objetivo: Se realiza un estudio retrospectivo a los pacientes sometidos a reimplante ureteral bilateral extravesical simultáneo y se reportan los resultados y la incidencia de retención urinaria transitoria. Métodos: Se evalúan a 127 pacientes con reflujo vesicoureteral primario a los que se les realizó reimplante ureteral bilateral simultáneo en un período de 8 años. El sexo fue femenino en 92 (72,4%) y masculino en 35 (27,6%). En todos los pacientes, al terminar el procedimiento, se dejó un catéter uretral tipo Foley en vejiga entre 24 y 72 horas. Postoperatoriamente se evaluaron con ultrasonidos del tracto urinario en el primer mes y con cistograma miccional en el tercero. Resultados: El seguimiento postoperatorio medio fue de 4.01 años. No hubo ningún caso de obstrucción ureteral. El cistograma postoperatorio demostró la resolución del reflujo vesicoureteral bilateral en 122 (96%) pacientes y persistencia del mismo en 5 (4%). Al retirar la sonda vesical postoperatoria 7/127 (5.5%) pacientes presentaron retención urinaria. Se han dividido los pacientes en dos grandes grupos basados en el tiempo y en las variantes técnicas quirúrgicas empleadas. El primero (junio de 1998 a enero de 2001) lo constituyen 57 reimplantes extravesicales bilaterales con 5 (8.7%) casos de retención urinaria transitoria, comenzando a miccionar de forma normal a las 24 horas, 48 horas, 72 horas, 5 días y 4 semanas cada uno de los niños. El segundo grupo (febrero de 2001 a Octubre de 2006) lo forman 70 reimplantes extravesicales bilaterales y hubo solo 2 (2.85%) casos de retención urinaria transitoria, comenzando a orinar los dos de forma normal a las 24 horas. Conclusiones: El reimplante vesicoureteral extravesical bilateral es un procedimiento con un elevado índice de éxito y una mínima morbilidad. Puede ocasionar disfunción miccional retencionista transitoria. En nuestra serie la utilización de cauteterización bipolar y una disección más limitada y cuidadosa del uréter distal, disminuyó la incidencia de retención urinaria transitoria postoperatoria (AU)

Objectives: We report the outcome and incidence of urinary retention after bilateral extravesical reimplant in patients with primary vesicoureteral reflux. Methods: We retrospectively evaluated the chart of 127 patients, 92 females and 35 males, who underwent correction of primary vesicoureteral reflux using the extravesical approach. Mean patient age at surgery was 3.93 years. Postoperatively the urethral catheter was removed after 24 to 72 hours and a voiding trial was done. Surgical outcomes were analyzed specifically for perioperative complications and resolution of reflux on postoperative VCUG. Results: Mean follow-up was 4.01 years. Postoperative VCUG showed resolution of reflux in 122 (96%) patients. Urinary retention developed in 7/127 patients (5.5%). In 57 patients in whom the surgery was done from 06-1998 to 01-2001, urinary retention developed in 5/57 (8.7%) for 1 day (1), 2 days (1), 5 days (2) and 4 weeks (1). In 70 patients in whom the surgery was done from 02-2001 to 10-2006, urinary retention developed in 2/70 (2.85%) for 1 day (2). Conclusions: Bilateral extravesical vesicoureteral reimplant can be associated with temporary urinary retention. In the last 5 years, with a careful and limited dissection close to the distal ureter and used of bipolar cautery when necessary, we were able to decreased the risk of postoperative urinary retention (AU)

Reflujo vesicoureteral contralateral despues del tratamiento endoscópico del reflujo unilateral primario / Contralateral vesicoureteral reflux after endoscopic treatment of primary unilateral reflux

Objetivo: conocer la incidencia de nuevo RVU contralateral y la evolución del mismo en los niños con reflujo vesicoureteral (RVU) primario unilateral sometidos a tratamiento endoscópico (TE). Métodos: En un periodo de 7,5 años se han realizado un total de 228 antirreflujos endoscópicos en niños con RVU esencial, de los cuales 90 (39,5%) han sido unilaterales. Los criterios de inclusión fueron padecer RVU unilateral primario tratado con TE y no haber tenido reflujo contralateral previo. Se valoraron: edad, sexo, número de cistouretrogramas miccionales seriados (CUMS) previos al procedimiento quirúrgico, grado y lado del RVU inicial y del contralateral, nefropatía ipsi y contralateral, indicaciones de la cirugía inicial, material y volumen utilizado para el TE, y evolución del reflujo. También se realiza una revisión actualizada de la literatura con un metaanálisis para comparar los resultados. Resultados: Seis niños (6,7%) presentaron nuevo RVU contralateral. La edad media fue de 3,3 años. El sexo fue masculino en 2 y femenino en 4. Los grados de RVU inicial fueron: II en uno, III en tres y IV en dos. Cuatro pacientes tenían historia de disfunción vesical. El nuevo RVU contralateral fue grado II en 5 niños y grado III en el restante. En cinco niños persistió RVU inicial, siempre de menor grado que el previo, y apareció el nuevo reflujo contralateral; y en uno solo desapareció en el lado inicial y se presentó en el contralateral. Los cinco niños con RVU bilateral se reinyectaron y curaron todos menos uno en que persistió el RVU inicial y está pendiente de reinyección. El niño que presentó solo RVU II contralateral está sometido a observación. En el metanálisis realizado se han encontrado nueve 9 trabajos y tiene una incidencia media de 8,2%. Conclusión: El RVU Contralateral es una complicación relativamente frecuente en los RVU unilaterales primarios tratados endoscópicamente, pero que no justifica realizar el tratamiento bilateral simultáneo. Éste solo está indicado si existe historia de RVU contralateral previo. La Etiología del RVU Contralateral no esta claramente establecida pero la disfunción vesical puede influir en su aparición (AU)

Objectives: To know the incidence of new contralateral VUR and its evolution in children with primary unilateral vesicoureteral reflux (VUR) managed with endoscopic treatment (ET). Methods: During 7.5 years a total of 228 children with primary VUR underwent endoscopic implantation of bulking material, 90 of them (39,5%) have been unilateral. The inclusion criterion was: unilateral primary VUR managed with ET, without previously contralateral VUR. Collected data included: patient age, gender, indications for surgery, number of preoperative cystourethrograms, preoperative and new contralateral postoperative VUR grades, nephropathy in the ipsilateral or contralateral sides, type and volume of bulking material used, and VUR outcome. An update bibliographic review with methanalysis is also performed to compare results. Results: Six children (6,7%) developed new contralateral VUR. Mean age was 3.3 years. Four patients were females and 2 males. The bulking material used was polydimethylsiloxane in one and Dextranomer/Non animal stabilished hyaluronic acid in 5. The initial grades of primary VUR were: II in 1 case, III in 3, and IV in 2. Four patients had previous history of bladder dysfunction. The new contralateral VUR was II in 5 and III in one. In 5 patients initial VUR persisted, always of lower grade than previously, and new contralateral VUR appeared. In one patient initial VUR disappeared and appeared in the contralateral side. Five patients were reinjected and VUR was cured, except one who is waiting for a new endoscopic procedure. One patient with grade II contralateral VUR is under observation. In the metanalysis performed nine issues have been found with an incidence of 8,2%. Conclusion: Contralateral VUR is a relatively frequent complication in unilateral primary VUR treated by endoscopic procedures (6.7%), but not enough as to perform bilateral endoscopic treatment in all unilateral VUR. Contralateral VUR etiology is not clear but bladder dysfunction can be an important factor (AU)

Obstrucción ureteral postoperatoria después de antirreflujo endoscópico / Postoperative ureteral obstruction after endoscopic antireflux therapy

Objetivo: El tratamiento endoscópico (TE) del reflujo vesicoureteral (RVU), está considerado por muchos urólogos y cirujanos pediátricos como la primera opción de tratamiento en caso de requerirse, debido a ser un procedimiento mínimamente invasivo, de corta duración, ambulatorio en muchos casos, con buenos resultados y escasas complicaciones; entre ellas la obstrucción ureteral es la mas grave pero la menos frecuente. Conocer la incidencia, manejo y evolución de los pacientes que presentaron obstrucción ureteral como complicación del TE del RVU. Método: Revisión de la literatura médica utilizando como buscadores Pubmed y Ovid. Revisión de los casos tratados con TE en el período comprendido entre Marzo de 1998 y Julio de 2007, un total de 377 niños (N) y 598 uréteres (U), para identificar los casos que presentaron obstrucción ureteral como complicación del TE. Resultados: Sólo 2 uréteres (0.33%), en dos niños (0.5%), presentaron Obstrucción Ureteral con repercusión en el TUS que precisó tratamiento. Conclusión: El riesgo de obstrucción ureteral en el postoperatorio del tratamiento endoscópico antirreflujo es muy bajo y en caso de presentarse existen varias alternativas para su manejo todas ellas con resultados satisfactorios (AU)

Objectives: The endoscopic treatment (ET) of vesicoureteral reflux (VUR) is considered by many urologic and pediatric surgeons as the first treatment option in the event of being required, because it is a minimally invasive procedure, of short duration, ambulatory in many cases, with good results and few complications. Ureteral obstruction is the most serious but less frequent complication. The objective is know the incidence, treatment and evolution of patients with ureteral obstruction as complication of the ET of VUR. Methods: Evaluation of the medical literature using Pubmed and Ovid. Revision of the clinical report of children (CH) under ET of VUR between March of 1998 and July of 2007, to find those cases that presented ureteral obstruction after ET. Results: A total of 377 children (CH) with VUR in 598 ureters (U), were treated with TE, during the mentioned period of 9 years, between March 1998 and July 2007. Only 2 U (0.33%), in 2 CH (0.5%) presented Ureteral Obstruction with dilatation of the upper urinary tract that need open surgical ureteral reimplantation, with good results in both patients. Conclusion: The risk of ureteral obstruction after ET of VUR is low, less than 0.5% of U. The treatment of this complication can be endoscópic or by open surgery both of them with good results (AU)