L García-Aparicio1, E Blázquez-Gómez2, A Vila Santandreu3, J A Camacho Diaz3, J Vila-Cots3, M Ramos Cebrian3, I de Haro4, O Martin5, X Tarrado4. 1. Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España. Electronic address: lgarcia@hsjdbcn.org. 2. Servicio de Anestesiología, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España. 3. Sección de Nefrología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España. 4. Servicio de Cirugía Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España. 5. Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España.
Abstract
INTRODUCTION: Some guidelines recommend an early voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR), but there's no consensus if it's necessary a long-term follow-up in these patients. The aim of our study is analyze if it's necessary a delayed VCUG after initial successful treatment with Dx/HA. MATERIAL AND METHOD: We have reviewed all medical charts of patients that underwent Dx/HA treatment from 2006 to 2010. We have selected patients with initial successful treatment and more than 3 years of radiological and clinical follow-up. We have analyzed late clinical and radiological outcomes. RESULTS: One hundred and sixty children with 228 refluxing ureters underwent Dx/HA endoscopic treatment with a mean follow-up of 52.13 months. Early VCUG was performed in 215 ureters with an initial successful rate of 84.1%. The group of study was 94/215 ureters with more than 3 years of follow-up with a delayed VCUG. VUR was still resolved in 79,8% of the ureters. Clinical success rate was 91.7%. The incidence of febrile urinary tract infection in those patients with cured VUR and those with a relapsed VUR was 8 and 15%, respectively; but there were no significant differences. We have not found any variable related with relapsed VUR except those ureters that initially received 2 injections (P<.05). CONCLUSION: If our objective in the treatment of VUR is to reduce the incidence of febrile urinary tract infection it is not necessary to perform a delayed VCUG even though the long-term radiological outcomes is worse than clinical outcome.
INTRODUCTION: Some guidelines recommend an early voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR), but there's no consensus if it's necessary a long-term follow-up in these patients. The aim of our study is analyze if it's necessary a delayed VCUG after initial successful treatment with Dx/HA. MATERIAL AND METHOD: We have reviewed all medical charts of patients that underwent Dx/HA treatment from 2006 to 2010. We have selected patients with initial successful treatment and more than 3 years of radiological and clinical follow-up. We have analyzed late clinical and radiological outcomes. RESULTS: One hundred and sixty children with 228 refluxing ureters underwent Dx/HA endoscopic treatment with a mean follow-up of 52.13 months. Early VCUG was performed in 215 ureters with an initial successful rate of 84.1%. The group of study was 94/215 ureters with more than 3 years of follow-up with a delayed VCUG. VUR was still resolved in 79,8% of the ureters. Clinical success rate was 91.7%. The incidence of febrile urinary tract infection in those patients with cured VUR and those with a relapsed VUR was 8 and 15%, respectively; but there were no significant differences. We have not found any variable related with relapsed VUR except those ureters that initially received 2 injections (P<.05). CONCLUSION: If our objective in the treatment of VUR is to reduce the incidence of febrile urinary tract infection it is not necessary to perform a delayed VCUG even though the long-term radiological outcomes is worse than clinical outcome.
Authors: L García-Aparicio; E Blázquez-Gómez; O Martin; S Pérez-Bertólez; J Arboleda; A Soria; X Tarrado Journal: World J Urol Date: 2018-05-03 Impact factor: 4.226