Primary Bilateral High-Grade Vesicoureteral Reflux in Children: Management Perspective

Qahtani, Wadha Al; Sarhan, Osama; Otay, Abdulhakim Al; Helaly, Ahmed El; Kawai, Fouad Al

doi:10.7759/cureus.12266

Cited by 4 publications

(1 citation statement)

References 30 publications

(84 reference statements)

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“…Although similar findings have been reported [9,10], some studies have reported either no sex bias or female predominance [8,11]. In this study, VUR demonstrated bilaterality in 43% of patients, compared with 28% for both isolated right-and left-sided VUR, which is consistent with the findings of studies conducted in Nepal, Sudan, Saudi Arabia, and Brazil (60%, 56%, 61%, and 54%, respectively) [10][11][12][13]. Most cases had severe VUR of grades 4 and 5 (68%), followed by mild (grades 1 and 2, 50%) and moderate (grade 3, 25%) VUR.…”

Section: Discussionsupporting

confidence: 90%

Relationship Between Vesicoureteric Reflux and Nephrocalcinosis in Children: A Case-Control Study at a Tertiary Medical Center in Saudi Arabia

Al-Zahrani¹,

Al-Faraj²,

Llaguno³

et al. 2022

Cureus

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Background: Vesicoureteral reflux (VUR), one of the most common pediatric congenital urogenital abnormalities, refers to the abnormal backflow of urine from the urinary bladder back into the ureter or to the kidney. This causes urinary tract infections. Nephrocalcinosis (NC) refers to abnormal deposits of calcium within the renal parenchyma and/or in the renal cortex. Patients with NC are mostly asymptomatic and severe disease may progress to renal failure. Early diagnosis through examinations such as radiography, computed tomography, and ultrasonography, is crucial for therapeutic treatment. Ultrasonography is the preferred method for scanning and grading nephrocalcinosis in children, primarily because it emits no radiation. This study aimed to increase the body of knowledge regarding VUR and nephrocalcinosis by determining its prevalence and assessing the relationship between VUR and nephrocalcinosis in children presenting at our institution.Methods: A case-control study was conducted using data from the medical records of 632 children younger than 14 years in a tertiary medical center in Riyadh, Saudi Arabia. Eligible participants were assigned to two groups: Group 1 consisted of 316 patients with VUR, while Group 2 consisted of 316 sex-and age-matched patients without VUR. The difference in the prevalence of nephrocalcinosis between the two groups was assessed. Frequency and percentage were used to present the categorical variables; Pearson productmoment correlation was utilized to establish the association between VUR and nephrocalcinosis. Statistical significance was established at p<0.05.Result: Only two cases in Group 1 were positive for nephrocalcinosis (0.63%, one male and one female), while four cases in Group 2 were positive for the condition (1.26%, two males and two females). There was no significant difference in the incidence of nephrocalcinosis between the two groups (p=0.873), indicating no relationship between VUR and nephrocalcinosis in children. Conclusion:There is no relationship between VUR and nephrocalcinosis in children under the age of 14 years.

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Section: Discussionsupporting

confidence: 90%

Relationship Between Vesicoureteric Reflux and Nephrocalcinosis in Children: A Case-Control Study at a Tertiary Medical Center in Saudi Arabia

Al-Zahrani¹,

Al-Faraj²,

Llaguno³

et al. 2022

Cureus

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Ureteroneocystostomy without ureteral remodeling for grade III–V vesicoureteral reflux treatment

Toni

Lombardo

Andolfi

et al. 2021

Journal of Pediatric Urology

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Investigating the clinical outcomes of bulking agent injection in comparison with modified Gil-Vernet anti-vesicoureteral reflux surgery in children with high-grade reflux (4 or 5)

Sharifiaghdas,

Narouie,

Soltani

et al. 2023

Afr J Urol

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Background Vesicoureteral reflux (VUR) is a common condition associated with childhood urinary tract infection (UTI) that can lead to chronic renal failure and hypertension. Various anti-reflux treatments were advocated, with various degrees of morbidity and success. The purpose of this study is to analyze and compare the results of modified Gil-Vernet anti-reflux surgery and bulking agent injection in children with unilateral high-grade reflux. Methods The study involved 179 patients who underwent surgical interventions for primary VUR from February 2013 to September 2019. Data on baseline demographics, preoperative symptoms, radiological imaging studies, and postoperative outcomes were analyzed. Treatment goal was defined as when no VUR or downgrading was detected 6 months or later after the intervention. Results A total of 128 patients underwent modified Gil-Vernet anti-reflux surgery and 51 patients underwent dextranomer/hyaluronic acid (Dx/HA) injection with mean VUR grading of 4.3 in both groups (P = 0.687). The overall VUR resolution rates were significantly higher in modified anti-reflux surgery rather than Dx/HA injection (86% vs. 68%, P = 0.021). Dx/HA injection was associated with shorter operation time (21 ± 8 min vs. 57 ± 11 min, P = 0.01), and shorter hospital stay (0.34 ± 0.22 days vs. 3.50 ± 0.50 days, P < 0.001). No major complications were identified in both groups. Conclusions Dx/HA injection has a significantly shorter operation time, lower postoperative analgesic usage, and shorter hospital stay, modified Gil-Vernet anti-reflux surgery is associated with significantly higher VUR downgrading and resolution rates than Dx/HA injection, particularly in the higher grade VUR.

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Primary Bilateral High-Grade Vesicoureteral Reflux in Children: Management Perspective

Cited by 4 publications

References 30 publications

Relationship Between Vesicoureteric Reflux and Nephrocalcinosis in Children: A Case-Control Study at a Tertiary Medical Center in Saudi Arabia

Relationship Between Vesicoureteric Reflux and Nephrocalcinosis in Children: A Case-Control Study at a Tertiary Medical Center in Saudi Arabia

Ureteroneocystostomy without ureteral remodeling for grade III–V vesicoureteral reflux treatment

Investigating the clinical outcomes of bulking agent injection in comparison with modified Gil-Vernet anti-vesicoureteral reflux surgery in children with high-grade reflux (4 or 5)

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