Postoperative cystography and endoscopic treatment of low-grade vesicoureteral reflux.
J Laparoendosc Adv Surg Tech A
; 18(3): 461-3, 2008 Jun.
Article
en En
| MEDLINE
| ID: mdl-18503385
ABSTRACT
INTRODUCTION:
The endoscopic subureteral injection of tissue-bulking agents has become an established alternative to long-term antibiotic prophylaxis and open surgery with a high success rate, especially for low-grade reflux (>90%). Though it is recognized that a routine postoperative voiding cystourethrography (VCUG) is unnecessary following a ureteroneocystostomy, most teams perform one after an endoscopic treatment. MATERIALS ANDMETHODS:
In this paper, we report on our experience with the endoscopic correction of vesicoureteral reflux in 72 ureteral units, for whom no routine postoperative cystography was performed.DISCUSSION:
Two children presented with postoperative recurrent febrile urinary tract infections (UTIs), which were not correlated with cystography findings. Postoperative VCUGs after a ureteroneocystostomy are invasive and expose the child to radiation, they are associated with a substantial cost, and most of all, they do not allow the identification of those patients at risk of recurrent febrile UTIs. Further, the endoscopic subureteral injection of tissue-bulking agents have been used for several years, and numerous studies, set in various clinical settings, have since been published, confirming excellent long-term results for low-grade reflux.CONCLUSIONS:
We feel that postoperative cystograms should be reserved for children who present with recurrent UTIs, new sonographic abnormalities, or who were treated for high-grade reflux.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Infecciones Urinarias
/
Reflujo Vesicoureteral
/
Materiales Biocompatibles
/
Dextranos
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Ácido Hialurónico
Tipo de estudio:
Diagnostic_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Año:
2008
Tipo del documento:
Article