Routine delayed voiding cystourethography after initial successful endoscopic treatment with Dextranomer/Hialuronic Acid Copolimer (Dx/HA) of vesicoureteral reflux (VUR). Is it necessary?

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.

• Authors: L García-Aparicio, E Blázquez-Gómez, A Vila Santandreu, J A Camacho Diaz, J Vila-Cots, M Ramos Cebrian, I de Haro, O Martin, X Tarrado
• Journal: Actas urologicas espanolas (Actas Urol Esp) Vol. 40 Issue 10 Pg. 635-639 (Dec 2016) ISSN: 1699-7980 [Electronic] Spain
• Vernacular Title: ¿Es necesario realizar una cistouretrografía miccional seriada (CUMS) tardía tras el tratamiento endoscópico exitoso inicial con copolímero de dextranómreo/ácido hialurónico (Dx/HA) para el reflujo vesicoureteral (RVU)?
• PMID: 27161091 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Chemical References

• Dextrans
• dextranomer-hyaluronic acid copolymer
• Hyaluronic Acid

Topics

• Child, Preschool
• Cystography
• Cystoscopy
• Dextrans (therapeutic use)
• Female
• Follow-Up Studies
• Humans
• Hyaluronic Acid (therapeutic use)
• Male
• Remission Induction
• Retrospective Studies
• Time Factors
• Ureteroscopy
• Urethra (diagnostic imaging)
• Urination
• Vesico-Ureteral Reflux (diagnostic imaging, therapy)