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Recurrence of vesico-ureteral reflux in children: is still the endoscopic injection the best option?
Nascimben, Francesca; Talon, Isabelle; Maldonado, Consuelo; Angotti, Rossella; Molinaro, Francesco; Moog, Raphael; Becmeur, Francois.
Affiliation
  • Nascimben F; Department of Pediatric Surgery, University Hospital of Hautepierre, Strasbourg, France.
  • Talon I; Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
  • Maldonado C; Department of Pediatric Surgery, University Hospital of Hautepierre, Strasbourg, France.
  • Angotti R; Department of Pediatric Surgery, University Hospital of Hautepierre, Strasbourg, France.
  • Molinaro F; Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
  • Moog R; Division of Pediatric Surgery, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
  • Becmeur F; Department of Pediatric Surgery, University Hospital of Hautepierre, Strasbourg, France.
Transl Androl Urol ; 13(8): 1446-1454, 2024 Aug 31.
Article in En | MEDLINE | ID: mdl-39280646
ABSTRACT

Background:

Endoscopic injection (EI) is a safe treatment for vesico-ureteral reflux (VUR) in children, but recurrences are not insignificant. This study aims to show if multiple EI is still the best first line management even if in case of recurrences.

Methods:

All patients affected by primary VUR, treated with at least one EI and with at least 5 years follow up were included. All general data were analyzed. Recurrence rate after one, two and three EIs were calculated.

Results:

One hundred and sixty-one patients (total number =210) were healed after 1 injection, 28 after 2 and 4 after 3 with a global success rate of 91.90%. Recurrence rate is higher in patients older than 3 years old and with IV and V reflux grade. Even if 67.7% of recurrent VUR after one injection was symptomatic, diagnosis of recurrences after multiple EI was mainly radiological. Only 8% of the patients underwent EI need an anti-reflux surgery.

Conclusions:

Thanks to its low costs and the acceptable recurrence rate, Deflux EI should be proposed as the first therapeutic approach for children affected by VUR, especially in those with low and moderate grades of VUR. Multiple injections could be contraindicated only in older children thank 1 year with high-grade VUR (IV symptomatic and V grade).
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Transl Androl Urol Year: 2024 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Transl Androl Urol Year: 2024 Document type: Article Affiliation country: Country of publication: