Evolution of the treatment of vesicoureteral reflux in Spain.

Abstract

PURPOSE:

We determined the changes in the treatment of vesicoureteral reflux (VUR) at children's hospitals in Spain as well as the long-term results of endoscopic treatment (ET) with polytetrafluoroethylene, namely with STING (subureteral polytetrafluoroethylene injection).

MATERIALS AND METHODS:

A survey was performed of all pediatric urology units in Spain to determine changes in the diagnosis and treatment of VUR in the last 10 years. Also, a conjoint study was made of STING case records at 5 Spanish hospitals where there is expertise in the technique.

RESULTS:

The response rate was 34 of 44 cases (78%). The most significant changes were the introduction of urodynamics and the progressive establishment of ET as a substitute for open surgery and prolonged medical treatment. At more than 90% of the units ET is now done with different materials with a cure rate of 75% after 1 injection and a low index of complications. The results of the STING study in 2,035 refluxing ureters showed a cure rate of about 90% for 2 or 3 injections for grades I to IV reflux and just under 70% for grade V. Also, the cure rate for complex reflux was 60% and the index of complications was less than 1.2% with some intravesical migration.

CONCLUSIONS:

There have been many changes in the approach to VUR with an increasing use of urodynamics and ET. Since the long-term results of STING are reliable and no long-term complications have been observed, polytetrafluoroethylene appears to be the product with the best quality/price ratio for use in ET. However, it is being replaced.

• Authors: Jose M Moran Penco, Andre Gomez Fraile, Jorge Rodríguez Alarcon, Francisco Garcia Merino, Diego Vela, Santiago Sanjuán Rodriguez, Aldolfo Aransay Brantot
• Journal: The Journal of urology (J Urol) Vol. 171 Issue 2 Pt 1 Pg. 834-7 (Feb 2004) ISSN: 0022-5347 [Print] United States
• PMID: 14713837 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Polytetrafluoroethylene

Topics

• Child
• Humans
• Injections
• Polytetrafluoroethylene (administration & dosage)
• Spain
• Surveys and Questionnaires
• Ureteroscopy (statistics & numerical data, trends)
• Vesico-Ureteral Reflux (therapy)