Treatment Outcomes of Subureteric Injection and Ureteroneocystostomy in Children with Vesicoureteral Reflux
Öz
Objective: This study was designed to evaluate
patients treated with subureteric injection (STING) and
ureteroneocystostomy by the Lich-Gregoir technique (LGT) due to
vesicoureteral reflux (VUR) in terms of radiologic, scintigraphic
images, laboratory findings and bladder functions and determine the
effectiveness of both treatment modalities.
Methods: A total of 106 patients, who were treated
with STING and ureteroneocystostomy between January 2002-2010 were
investigated. Patients’ age, gender, complaints at presentation, bladder
function impairment, laboratory outcome and radiologic and
scintigraphic findings were retrospectively examined. The relationship
among VUR grades and pelvicalyceal ectasia, scars, treatment modalities
and outcome were evaluated.
Results: Left VUR was found in 68(64%) and right VUR
in 38(36%) of the patients. The most common level of VUR was Grade III
(42 patients, 40%). Additional urologic pathologies were found in 60 of
the 106 of patients (57%). Pelvicalyceal ectasia was found in 44 (42%)
and scars were seen in dimercaptosuccinic acid (DMSA) in 54 (51%) of the
patients. In total 86 (81%) of 106 patients with VUR recovered
completely and 20 (19%) patients with VUR regressed.
Conclusion: STING is a good alternative especially for
patients with low grade VUR. However, it has some drawbacks, such as
requiring a long follow-up period, having a lower rate of success
compared to open surgery and being less effective in patients with high
grade VUR. Ureteroneocystostomy (LGT) is a method with less morbidity
and a high success rate, especially in the treatment of patients with
higher grade VUR. J Clin Exp Invest 2016; 7 (2): 168-173
Anahtar Kelimeler
Children vesicoureteral reflux reflux nephropathy subureteric injection
Kaynakça
- 1. Tarcan T, Akbal C, Tavukçu HH, et al. The cost-effectiveness of endoscopic treatment and open surgery in the manage - ment of vesicoureteral reflux. Pediatr Urol 2007;33:86-91. 2. Greenbaum LA, Mesrobian HG. Vesicoureteral reflux. Pedi - atr Clin North Am 2006;53:413-27. 3. Jask SE. Vezikoüreteral reflüde cerrahi tedavi. In: Puri P, Hollwarth M, (Çev: Başaklar AC) (eds), Çocuk Cerrahisi. Palme Yayıncılık, 2009; Ankara, ss 499-514. 4. Başaklar AC. Vezikoüreteral reflü. In: Başaklar AC (ed). Be - bek ve Çocukların Cerrahi ve Ürolojik Hastalıkları. Palme yayıncılık, 2006; Ankara, ss 1289-333. 5. Alon US, Ganapathy S. Should renal ultrasonography be done routinely in children with first urinary tract infection? Clin Pediatr (Phila) 1999;38:21-5. 6. Hoberman A, Charron M, Hickey RW, et al. Imaging studies after a first febrile urinary tract infection in young children. N Engl J Med 2003;16:195-202. 7. McKerrow W, Davidson-Lamb N, Jones PF. Urinary tract infection in children. Br Med J (Clin Res Ed) 1984;4:299- 303. 8. Bensman A, Dun and O, Ulinski T. Urinary tract infection. In: Avner ED, Harmon WE, Niaudet P, Yoshikawa N (eds), Pe - diatric Nephrology (6th ed). Lippincott Williams-Wilkins, Baltimore. 2009; pp 1199-1210. 9. Ander H, Şanlı Ö. Vezikoüreteral reflü ve megaüreter. In: Anafarta K, Yaman Ö (eds), Temel Üroloji (3rd ed). Güneş Kitabevi, Ankara, 2005; pp 2053-2016. 10. Williams G, Craig JC. Diagnosis and management of uri - nary tract infections. In: Geary DF, Schaefer F (eds). Com - prehensive Pediatric Nephrology. Mosby, Philadelphia. 2008; pp 539-48. 11. Öksüz M (2009) Üriner sistem enfeksiyonu olan çocuk hastaların retrospektif değerlendirilmesi. Expertise Thesis, Pediatrics Department, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey. 12. McLorie GA, McKenna PH, Jumper BM, et al. Highgrade vesicoureteral reflux: analysis of observational therapy. J Urol 1990;144:537-40. 13. Homayoon K, Chen JJ, Cummings JM, Steinhardt GF. Voiding dysfunction: outcome in infants with congenital vesicoureteral reflux. Urology 2005;66:1091-4. 14. Soygür T, Arikan N, Yeşilli C, et al. Relationship among pediatric voiding dysfunction and vesicoureteral reflux and renal scars. Urology 1999;54:905-8. 15. Mayo ME, Burns MW. Urodynamic studies in children who wet. Br J Urol 1990;65:641-5. 16. Claësson I, Jacobsson B, Jodal U, et al. Early detection of nephropathy in childhood urinary tract infection. Acta Ra - diol Diagn (Stockh) 1981;22:315-20. 17. Salih M, Baltaci S, Kiliç S, et al. Color flow Doppler so - nography in the diagnosis of vesicoureteric reflux. Eur Urol 1994;26:93-7. 18. Üner Ç, Yıldız YT, Erdoğan Ö. How much should we rely on ultrasonographic findings in vesicoureteral reflux? Türk Pediatri Arşivi 2003;38:32-35. 19. Cooper CS. Diagnosis and management of vesicoureteral reflux in children. Nat Rev Urol. 2009;6:481-489. 20. Lee HY, Soh BH, Hong CH, et al. The efficacy of ultra - sound and dimercaptosuccinic acid scan in predicting vesi - coureteral reflux in children below the age of 2 years with their first febrile urinary tract infection. Pediatr Nephrol 2009;24:2009-2013. 21. Tullus K. Vesicoureteric reflux in children. Lancet. 2015;385:371-9. 22. Bellinger MF, Duckett JW. Vesicoureteral reflux: a com - parison of non-surgical and surgical management. Contrib Nephrol 1984;39:81-93. 23. Macedo CS, Riyuzo MC, Bastos HD. Renal scars in chil - dren with primary vesicoureteral reflux. J Pediatr (Rio J) 2003;79:355-62. 24. Capozza N, Lais A, Matarazzo E, et al. Treatment of vesico- ureteric reflux: a new algorithm based on parental prefer - ence. BJU Int 2003;92:285-288. 25. Läckgren G, Wåhlin N, Sköldenberg E, et al. Long-term follow-up of children treated with dextranomer/hyal - uronic acid copolymer for vesicoureteral reflux J Urol 2001;166:1887-92. 26. Tekgül S, Riedmiller H, Hoebeke P, et al. European Asso - ciation of Urology. EAU guidelines on vesicoureteral reflux in children. Eur Urol 2012;62:534-42. 27. Zambaiti E, Pensabene M, Montano V, et al. Ultrasono - graphic mound height as predictor of vesicoureteral reflux resolutionafter endoscopic treatment in children. J Pediatr Surg 2016;13:63-6. 28. Karakurt GA, Hakgüder G, Ateş O. Subureteric implant injection in the treatment of vesico-ureteral reflux. Dokuz Eylül Üniversitesi Medical Journal 2009;23:59-64.
Öz
Kaynakça
- 1. Tarcan T, Akbal C, Tavukçu HH, et al. The cost-effectiveness of endoscopic treatment and open surgery in the manage - ment of vesicoureteral reflux. Pediatr Urol 2007;33:86-91. 2. Greenbaum LA, Mesrobian HG. Vesicoureteral reflux. Pedi - atr Clin North Am 2006;53:413-27. 3. Jask SE. Vezikoüreteral reflüde cerrahi tedavi. In: Puri P, Hollwarth M, (Çev: Başaklar AC) (eds), Çocuk Cerrahisi. Palme Yayıncılık, 2009; Ankara, ss 499-514. 4. Başaklar AC. Vezikoüreteral reflü. In: Başaklar AC (ed). Be - bek ve Çocukların Cerrahi ve Ürolojik Hastalıkları. Palme yayıncılık, 2006; Ankara, ss 1289-333. 5. Alon US, Ganapathy S. Should renal ultrasonography be done routinely in children with first urinary tract infection? Clin Pediatr (Phila) 1999;38:21-5. 6. Hoberman A, Charron M, Hickey RW, et al. Imaging studies after a first febrile urinary tract infection in young children. N Engl J Med 2003;16:195-202. 7. McKerrow W, Davidson-Lamb N, Jones PF. Urinary tract infection in children. Br Med J (Clin Res Ed) 1984;4:299- 303. 8. Bensman A, Dun and O, Ulinski T. Urinary tract infection. In: Avner ED, Harmon WE, Niaudet P, Yoshikawa N (eds), Pe - diatric Nephrology (6th ed). Lippincott Williams-Wilkins, Baltimore. 2009; pp 1199-1210. 9. Ander H, Şanlı Ö. Vezikoüreteral reflü ve megaüreter. In: Anafarta K, Yaman Ö (eds), Temel Üroloji (3rd ed). Güneş Kitabevi, Ankara, 2005; pp 2053-2016. 10. Williams G, Craig JC. Diagnosis and management of uri - nary tract infections. In: Geary DF, Schaefer F (eds). Com - prehensive Pediatric Nephrology. Mosby, Philadelphia. 2008; pp 539-48. 11. Öksüz M (2009) Üriner sistem enfeksiyonu olan çocuk hastaların retrospektif değerlendirilmesi. Expertise Thesis, Pediatrics Department, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey. 12. McLorie GA, McKenna PH, Jumper BM, et al. Highgrade vesicoureteral reflux: analysis of observational therapy. J Urol 1990;144:537-40. 13. Homayoon K, Chen JJ, Cummings JM, Steinhardt GF. Voiding dysfunction: outcome in infants with congenital vesicoureteral reflux. Urology 2005;66:1091-4. 14. Soygür T, Arikan N, Yeşilli C, et al. Relationship among pediatric voiding dysfunction and vesicoureteral reflux and renal scars. Urology 1999;54:905-8. 15. Mayo ME, Burns MW. Urodynamic studies in children who wet. Br J Urol 1990;65:641-5. 16. Claësson I, Jacobsson B, Jodal U, et al. Early detection of nephropathy in childhood urinary tract infection. Acta Ra - diol Diagn (Stockh) 1981;22:315-20. 17. Salih M, Baltaci S, Kiliç S, et al. Color flow Doppler so - nography in the diagnosis of vesicoureteric reflux. Eur Urol 1994;26:93-7. 18. Üner Ç, Yıldız YT, Erdoğan Ö. How much should we rely on ultrasonographic findings in vesicoureteral reflux? Türk Pediatri Arşivi 2003;38:32-35. 19. Cooper CS. Diagnosis and management of vesicoureteral reflux in children. Nat Rev Urol. 2009;6:481-489. 20. Lee HY, Soh BH, Hong CH, et al. The efficacy of ultra - sound and dimercaptosuccinic acid scan in predicting vesi - coureteral reflux in children below the age of 2 years with their first febrile urinary tract infection. Pediatr Nephrol 2009;24:2009-2013. 21. Tullus K. Vesicoureteric reflux in children. Lancet. 2015;385:371-9. 22. Bellinger MF, Duckett JW. Vesicoureteral reflux: a com - parison of non-surgical and surgical management. Contrib Nephrol 1984;39:81-93. 23. Macedo CS, Riyuzo MC, Bastos HD. Renal scars in chil - dren with primary vesicoureteral reflux. J Pediatr (Rio J) 2003;79:355-62. 24. Capozza N, Lais A, Matarazzo E, et al. Treatment of vesico- ureteric reflux: a new algorithm based on parental prefer - ence. BJU Int 2003;92:285-288. 25. Läckgren G, Wåhlin N, Sköldenberg E, et al. Long-term follow-up of children treated with dextranomer/hyal - uronic acid copolymer for vesicoureteral reflux J Urol 2001;166:1887-92. 26. Tekgül S, Riedmiller H, Hoebeke P, et al. European Asso - ciation of Urology. EAU guidelines on vesicoureteral reflux in children. Eur Urol 2012;62:534-42. 27. Zambaiti E, Pensabene M, Montano V, et al. Ultrasono - graphic mound height as predictor of vesicoureteral reflux resolutionafter endoscopic treatment in children. J Pediatr Surg 2016;13:63-6. 28. Karakurt GA, Hakgüder G, Ateş O. Subureteric implant injection in the treatment of vesico-ureteral reflux. Dokuz Eylül Üniversitesi Medical Journal 2009;23:59-64.
Ayrıntılar
| Konular | Sağlık Kurumları Yönetimi |
|---|---|
| Bölüm | Araştırma Yazısı |
| Yazarlar | |
| Yayımlanma Tarihi | 16 Haziran 2016 |
| Yayımlandığı Sayı | Yıl 2016 Cilt: 7 Sayı: 2 |