Routine delayed voiding cystourethography after initial successful endoscopic treatment with dextranomer/hyaluronic acid copolymer (Dx/HA) of vesicoureteral reflux (VUR). Is it necessary?

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• 作者：L. Garcí ; a-Aparicio^a ; ^{lgarcia@hsjdbcn.org} ; E. Blá ; zquez-Gó ; mez^b ; A.V. Santandreu^c ; J.A.C. Diaz^c ; J. Vila-Cots^c ; M.R. Cebrian^c ; I. de Haro^d ; O. Martin^a ; X. Tarrado^d
• 关键词：Vesicoureteral reflux ; Endoscopy ; Children ; Cystography
• 刊名：Actas Urológicas Españolas (English Edition)
• 出版年：2016
• 出版时间：December 2016
• 年：2016
• 卷：40
• 期：10
• 页码：635-639
• 全文大小：388 K
• 卷排序：40

文摘

Some guidelines recommend an early voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR), but there is no consensus if it is necessary a long-term follow-up in these patients. The aim of our study is analyze if it is necessary a delayed VCUG after initial successful treatment with Dx/HA.Material and methodWe 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.ResultsOne 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).ConclusionIf 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.