Influence of Voiding Dysfunction on the Outcome of Endoscopic Treatment for Vesicoureteral Reflux

Capozza, Nicola; Lais, Alberto; Matarazzo, Ennio; Nappo, Simona Gerocarni; Patricolo, Mario; Caione, Paolo

doi:10.1016/s0022-5347(05)64391-1

Cited by 56 publications

(21 citation statements)

References 19 publications

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“…Capozza et al [9] noted that almost all patients with treatment failure who had displacement of the Dx/HA mound also had concomitant voiding dysfunction and ascribed displacement to high voiding pressures secondary to voiding dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic mound height as predictor of vesicoureteral reflux resolution after endoscopic treatment in children

Zambaiti

Pensabene

Montano

et al. 2016

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Ultrasonographic mound height as predictor of vesicoureteral reflux resolution after endoscopic treatment in children

Zambaiti

Pensabene

Montano

et al. 2016

Journal of Pediatric Surgery

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“…16 It is believed that endoscopic treatment of VUR in children with dysfunctional voiding has an unfavourable outcome. 20 This has been attributed to the displacement of the Dx/HA implant in children with voiding dysfunction because high intravesical pressure caused by uninhibited detrusor contractions may cause displacement of the Dx/HA implant. Cappozza et al found a displaced implant in 27 children at re-treatment after initial treatment failure, and of these 27 children, 25 had dysfunctional voiding.…”

Section: Discussionmentioning

confidence: 99%

“…Cappozza et al found a displaced implant in 27 children at re-treatment after initial treatment failure, and of these 27 children, 25 had dysfunctional voiding. 20 Since we started treating VUR endoscopically, we have not considered BBD as a contraindication to endoscopic treatment. We only treat dysfunctional voiding when it persists after successful correction of VUR.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Febrile Urinary Tract Infections in Children after Successful Endoscopic Treatment of Vesicoureteral Reflux: A Long-Term Follow-Up

Hunziker

Mohanan

D’Asta

et al. 2012

The Journal of Pediatrics

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Objective To evaluate the incidence of febrile urinary tract infection (UTI) after successful endoscopic correction of intermediate and high-grade vesicoureteral reflux (VUR).Study design Medical records of 1271 consecutive children (male, 411; female, 903) who underwent successful endoscopic correction of VUR were reviewed. Factors potentially influencing postoperative UTIs, such as history of presentation, age, sex, grade of VUR, renal scarring, and agent used for the endoscopic injection, were analyzed.Results Febrile UTI developed in 73 children (5.7%) after successful endoscopic correction of VUR. Thirty-nine children had a single episode of UTI, and 34 children had two or more episodes at 1 month to 5.9 years (median, 1 year) after correction of VUR. With multivariate analysis, female sex (P < .001), history of preoperative bladder/ bowel dysfunction (BBD; P = .005), and BBD after endoscopic correction (P = .001) were revealed to be the most important independent risk factors for a febrile UTI after successful correction of VUR. ConclusionsThe incidence of febrile UTIs after successful correction of intermediate and high grade VUR is low.Female sex and BBD were the most important risk factors in the development of febrile UTI. Our data supports the importance of assessing bladder and bowel habits in older children with febrile UTIs after endoscopic correction of VUR. (J Pediatr 2012;-:---).V esicoureteral reflux (VUR) is the most common urinary tract abnormality in pediatrics, occurring in 1% to 2% of children, including 30% to 40% of children with urinary tract infection (UTI). 1,2 The association of VUR, febrile UTI, and renal parenchymal damage is well recognized. Reflux nephropathy is a cause of childhood hypertension and chronic renal failure. 3 Marra et al reviewed data on children with chronic renal failure who had high-grade VUR in the Italkid project, a database of Italian children with chronic renal failure, and found that those with VUR accounted for 26% of all children with chronic renal failure. The various treatment options currently available for VUR are: (1) long term antibiotic prophylaxis; (2) open surgical treatment; (3) minimally invasive endoscopic treatment; and (4) observation or intermittent therapy with management of bladder/bowel dysfunction (BBD) and treatment of UTI as they occur.Since United States Food and Drug administration approval in 2001 of dextranomer hyaluronic acid (Dx/HA) as a tissue augmenting substance for subureteral injection, endoscopic treatment has become a widely accepted minimally invasive alternative in the management of VUR.The main goals of treatment of children with VUR are to prevent renal parenchymal damage and morbidity associated with recurrent febrile UTIs. Relatively few studies have examined the incidence of febrile UTIs after successful resolution of VUR with endoscopic injection. The duration of follow-up in most series has been short, with conflicting rates of incidence of UTI. Febrile UTIs after successful resolution of VUR have been reported a...

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“…These commonly include preoperative VUR grade [20], presence of complicating anatomy [21,22], presence of voiding dysfunction [23], surgeon skill/experience [24,25], injected volume and technique of injection [26], intraoperative mound endoscopic appearance [27], and outcome definition [6,28].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative ultrasound-assisted approach for endoscopic treatment of vesicoureteral reflux in children

Zambaiti

Sergio

Casuccio

et al. 2017

Journal of Pediatric Surgery

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Influence of Voiding Dysfunction on the Outcome of Endoscopic Treatment for Vesicoureteral Reflux

Cited by 56 publications

References 19 publications

Ultrasonographic mound height as predictor of vesicoureteral reflux resolution after endoscopic treatment in children

Ultrasonographic mound height as predictor of vesicoureteral reflux resolution after endoscopic treatment in children

Incidence of Febrile Urinary Tract Infections in Children after Successful Endoscopic Treatment of Vesicoureteral Reflux: A Long-Term Follow-Up

Intraoperative ultrasound-assisted approach for endoscopic treatment of vesicoureteral reflux in children

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