Is a secondary procedure necessary in every case of failed endoscopic treatment for vesicoureteral reflux?
Korean Journal of Urology
; : 398-404, 2015.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-76176
Responsible library:
WPRO
ABSTRACT
PURPOSE:
Endoscopic treatment (ET) has become a widely accepted procedure for treating vesicoureteral reflux (VUR). However, patients followed up after ET over long periods have reported persistent or recurrent VUR. We evaluated the natural course of failed ET in patients who required further treatments to help physicians in making decisions on the treatment of VUR. MATERIALS ANDMETHODS:
We retrospectively reviewed the medical records of patients who were diagnosed with VUR and underwent ET from January 2006 to December 2009. A total of 165 patients with 260 ureters underwent ET. We compared the parameters of the patients according to ET success or failure and evaluated the natural course of the patients after ET failure.RESULTS:
Mean VUR grade and positive photon defect were higher in the failed ET group than in the successful ET group. Six months after the operation, persistent or recurrent VUR was observed in 76 ureters (29.2%), and by 16.3 months after the operation, VUR resolution was observed in 18 ureters (23.7%). Twenty-five ureters (32.9%) without complications were observed conservatively. Involuntary detrusor contraction was found in 1 of 9 (11.1%) among the secondary ET success group, whereas in the secondary ET failure group, 4 of 6 (66.7%) had accompanying involuntary detrusor contraction.CONCLUSIONS:
Patients in whom ET fails can be observed for spontaneous resolution of VUR unless they have febrile urinary tract infection or decreased renal function. Urodynamic study may be helpful in deciding whether a secondary procedure after ET failure is necessary.
Full text:
Available
Database:
WPRIM (Western Pacific)
Main subject:
Urodynamics
/
Vesico-Ureteral Reflux
/
Urinary Bladder
/
Retrospective Studies
/
Treatment Outcome
/
Treatment Failure
/
Cystoscopy
/
Muscle, Smooth
Type of study:
Observational study
/
Prognostic study
Limits:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Infant, Newborn
Language:
English
Journal:
Korean Journal of Urology
Year:
2015
Document type:
Article