Comparative retrospective study for surgically treated primary VUR in pediatric patients
Journal
Kosova Journal of surgery
Date Issued
2023-03
Author(s)
Radmila Mila Mihajlova Ilie
Magdalena Gjorik Petrushevska
Gani Çeku
Marijan Kamilovski
Njomza Lumani
Abstract
Introduction
Vesicoureteral reflux have incidence of about 1% in
pediatric population. It is a very common pediatric condition. Anomalies of the ureter, the dynamics of the bladder,
and the anatomy of the ureterovesical junction can lead to
abnormal valve mechanisms and vesicoureteral reflux.
Aim
The purpose of this study is to evaluate the effectiveness
of open and endoscopic urethral reimplantation in relation to
the severity of the vesicoureteral reflux and renal function. Materials and Methods
We retrospectively analyzed 53 children treated for
primary vesicoureteral reflux at the Clinic of Pediatric
Surgery in Skopje in the period from 2017 to 2020.
Endoscopic treatment was done using subureteric Teflon injection “STING” technique. Operative treatment
(open procedure) was used in higher grade vesicoureteral reflux (3 or 4). The evaluation of the results of the
treatment was done mainly according to the following
criteria: reduced grade of reflux, maintaining renal
function, absence of urinary infection and postoperative
complications. These outcomes were compared between
the two techniques. Results and Discussion
The endoscopic procedure was shown to be superior
for lower grade vesicoureteral reflux. The open procedure
is preferable in cases of higher vesicoureteral reflux or after failure with the endoscopic procedure.
Conclusion
Treatment of vesicoureteral reflux with the endoscopic
procedure is always preferable due to fewer days of hospitalization and as a minimally invasive approach. Both
procedures proved to be effective in reflux correction, and
successfully reduce the occurrence of febrile urinary tract
infections.
Vesicoureteral reflux have incidence of about 1% in
pediatric population. It is a very common pediatric condition. Anomalies of the ureter, the dynamics of the bladder,
and the anatomy of the ureterovesical junction can lead to
abnormal valve mechanisms and vesicoureteral reflux.
Aim
The purpose of this study is to evaluate the effectiveness
of open and endoscopic urethral reimplantation in relation to
the severity of the vesicoureteral reflux and renal function. Materials and Methods
We retrospectively analyzed 53 children treated for
primary vesicoureteral reflux at the Clinic of Pediatric
Surgery in Skopje in the period from 2017 to 2020.
Endoscopic treatment was done using subureteric Teflon injection “STING” technique. Operative treatment
(open procedure) was used in higher grade vesicoureteral reflux (3 or 4). The evaluation of the results of the
treatment was done mainly according to the following
criteria: reduced grade of reflux, maintaining renal
function, absence of urinary infection and postoperative
complications. These outcomes were compared between
the two techniques. Results and Discussion
The endoscopic procedure was shown to be superior
for lower grade vesicoureteral reflux. The open procedure
is preferable in cases of higher vesicoureteral reflux or after failure with the endoscopic procedure.
Conclusion
Treatment of vesicoureteral reflux with the endoscopic
procedure is always preferable due to fewer days of hospitalization and as a minimally invasive approach. Both
procedures proved to be effective in reflux correction, and
successfully reduce the occurrence of febrile urinary tract
infections.
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