Selective endoscopic treatment of the non-refluxing contralateral ureter prevents new contralateral vesicoureteral reflux

Abstract Objective The objective of this study was to evaluate risk factors for new contralateral vesicoureteral reflux (NCVUR) and to investigate whether assessment of the non-refluxing contralateral ureter (NRCU) by hydrodistention and selective treatment can reduce the incidence of NCVUR. Materia...

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Bibliographic Details
Published in:Journal of pediatric urology 2013-02, Vol.9 (1), p.51-55
Main Authors: Cerwinka, Wolfgang H, Kaye, Jonathan D, Leong, Traci L, Elmore, James M, Scherz, Hal C, Kirsch, Andrew J
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Dextrans - therapeutic use
Endoscopic treatment
Endoscopy
Female
Follow-Up Studies
Humans
Hyaluronic Acid - therapeutic use
Incidence
Infant
Injections, Intralesional - methods
Male
New contralateral vesicoureteral reflux
Pediatrics
Prevention
Risk Factors
Secondary Prevention
Treatment Outcome
Ureter
Urology
Vesico-Ureteral Reflux - drug therapy
Vesico-Ureteral Reflux - epidemiology
Vesico-Ureteral Reflux - prevention & control
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Summary:Abstract Objective The objective of this study was to evaluate risk factors for new contralateral vesicoureteral reflux (NCVUR) and to investigate whether assessment of the non-refluxing contralateral ureter (NRCU) by hydrodistention and selective treatment can reduce the incidence of NCVUR. Materials and methods From 2001 to 2007, 339 of 841 patients (40%) were treated for unilateral VUR by endoscopic injection. While in the first 267 patients the NRCU was only assessed by hydrodistention but not injected (observation group), NRCUs of the subsequent 72 patients were prophylactically treated if deemed at high risk for NCVUR (H2 or H3) (prophylaxis group). Results NCVUR occurred in 30 of 267 patients (11.2%) whose NRCUs were observed. No statistically significant risk factors for NCVUR were found in this group. In the subsequent 72 patients, whose H2 and H3 ureters were selectively injected ( N  = 56), no cases of NCVUR were seen. Conclusions Prophylactic endoscopic treatment of NRCU H2 and H3 ureters successfully prevented the occurrence of NCVUR.
ISSN:1477-5131
1873-4898
DOI:10.1016/j.jpurol.2011.11.013