Yıl: 2022 Cilt: 29 Sayı: 8 Sayfa Aralığı: 874 - 878 Metin Dili: İngilizce DOI: 10.5455/annalsmedres.2022.03.083 İndeks Tarihi: 30-09-2022

Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood

Öz:
Aim: It is aimed to evaluate the effect of reflux time in primary VUR in terms of predicting endoscopic treatment success and treatment timing in VUR management. Vesicoureteral reflux (VUR) is an important cause of urinary tract infection and chronic renal disease. Voiding cystourethrography (VCUG) is the gold standard diagnostic test in the diagnosis of VUR. In recent years, new parameters related to VCUG have been more objectively studied to evaluate the clinical prognosis. Materials and Methods: In our study, the records and imaging findings of children with primary VUR who underwent VCUG examination between 2012 and 2019, who were treated with endoscopic injections, were retrospectively reviewed. Forty-one children (67 renal units) were included in our study. Patients with preoperative VCUG, urinary ultrasonography, dimercaptosuccinic acid (DMSA) renal scan, and post-operative control VCUG were included in this study. Results: Patients with preoperative VUR grade 1-2 were divided into two groups as “low grade” and patients with stage 3-4-5 as “high grade”. In the general patient pop- ulation, endoscopic success rates in terms of renal unit deficit were found to be 46.3% (31/67). When the subgroup was analyzed, the endoscopic treatment success rate was 72.2% (13/18) in the low-grade group, versus 36.7% (18/49) in the high-grade group (p = 0.010). In the multivariate logistic regression analysis performed to identify indepen- dent predictors of scarring, reflux degree and reflux time were found to be independent predictors of scarring. Conclusion: In our study, we found that in VCUG evaluated preoperatively, VUR time as well as VUR grade were effective on endoscopic success rate and scar development. Based on these results, it could be thought that VUR time may be effective in selecting the best candidates for surgery and in the management and timing of treatment of VUR patients.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Payza AD, Hoşgör M, Serdaroğlu E, Sencan A. Can distal ureteral diameter measurement predict primary vesicoureteral reflux clinical outcome and success of endoscopic injection? J Pediatr Urol. 2019 Oct;15(5):515.e1-515.e8.
  • 2. Swanton AR, Arlen AM, Alexander SE, Kieran K, Storm DW, Cooper CS. Inter-rater reliability of distal ureteral diam- eter ratio compared to grade of VUR. J Pediatr Urol. 2017 Apr;13(2):207.e1-207.e5.
  • 3. Estrada CR, Jr., Passerotti CC, Graham DA, Peters CA, Bauer SB, Diamond DA, et al. Nomograms for predicting annual res- olution rate of primary vesicoureteral reflux: results from 2,462 children. The Journal of urology. 2009;182:1535-41.
  • 4. Blais AS, Bolduc S, Moore K. Vesicoureteral reflux: From prophylaxis to surgery. Can Urol Assoc J. 2017 Jan-Feb;11(1- 2Suppl1):S13-S18.
  • 5. Wang PZT, Abdelhalim A, Walia A, Wehbi E, Dave S, Khoury A. Avoiding routine postoperative voiding cystourethrogram: Predicting radiologic success for endoscopically treated vesi- coureteral reflux. Can Urol Assoc J. 2019 May;13(5):E119-E124.
  • 6. Peters CA, Skoog SJ, Arant BS Jr, Copp HL, Elder JS, Hud- son RG, Khoury AE, Lorenzo AJ, Pohl HG, Shapiro E, Snod- grass WT, Diaz M. Summary of the AUA Guideline on Manage- ment of Primary Vesicoureteral Reflux in Children. J Urol. 2010 Sep;184(3):1134-44.
  • 7. Mattoo TK. Vesicoureteral reflux and reflux nephropathy. Adv Chronic Kidney Dis. 2011 Sep;18(5):348-54.
  • 8. Orellana P, Baquedano P, Rangarajan V, Zhao JH, Eng ND, Fet- tich J, Chaiwatanarat T, Sonmezoglu K, Kumar D, Park YH, Samuel AM, Sixt R, Bhatnagar V, Padhy AK. Relationship be- tween acute pyelonephritis, renal scarring, and vesicoureteral re- flux. Results of a coordinated research project. Pediatr Nephrol. 2004 Oct;19(10):1122-6.
  • 9. Lee LC, Lorenzo AJ, Koyle MA. The role of voiding cys- tourethrography in the investigation of children with urinary tract infections. Can Urol Assoc J. 2016 May-Jun;10(5-6):210- 214.
  • 10. Bush NC, Keays M, Adams C, Mizener K, Pritzker K, Smith W, Traylor J, Villanueva C, Snodgrass WT. Renal damage detected by DMSA, despite normal renal ultrasound, in children with febrile UTI. J Pediatr Urol. 2015 Jun;11(3):126.e1-7.
  • 11. Arsanjani A, Alagiri M. Identification of filling versus void- ing reflux as predictor of clinical outcome. Urology. 2007 Aug;70(2):351-4.
  • 12. Nasrallah PF, Conway JJ, King LR, Belman AB, Weiss S. Quan- titative nuclear cystogram. Aid in determining spontaneous res- olution of vesicoureteral reflux. Urology 1978;12(6): 654e8.
  • 13. Lee JN, Lee SM, Ha YS, Kim BS, Kim HT, Kim TH, Yoo ES, Kwon TG, Chung SK. VUR timing on VCUG as a predictive factor of VUR resolution after endoscopic therapy. J Pediatr Urol. 2016 Aug;12(4):255.e1-6.
  • 14. Papachristou F, Printza N, Doumas A, Koliakos G. Urinary bladder volume and pressure at reflux as prognostic of vesi- coureteral reflux factors outcome. Pediatr Radiol 2004;34(7): 556e9.
  • 15. Quirino IG, Silva JM, Diniz JS, et al. Combined use of late phase dimercapto-succinic acid renal scintigraphy and ultrasound as firstline screening after urinary tract infection in children. J Urol. 2011;185:258–63.
  • 16. Guerra LA, Keays MA, Purser MJ, Wang SY, Leonard MP. Pe- diatric cystogram: Are we considering age-adjusted bladder ca- pacity? Can Urol Assoc J. 2018 Jun 19;12(12):378–81.
  • 17. Alexander SE, Arlen AM, Storm DW, Kieran K, Cooper CS. Bladder volume at onset of vesicoureteral reflux is an indepen- dent risk factor for breakthrough febrile urinary tract infection. The Journal of urology. 2015;193:1342-6.
  • 18. Schwab CW Jr, Wu HY, Selman H, Smith GH, Snyder HM 3rd, Canning DA. Spontaneous resolution of vesicoureteral reflux: a 15-year perspective. J Urol. 2002 Dec;168(6):2594-9.
  • 19. Sjöström S, Sillén U, Bachelard M, Hansson S, Stokland E. Spon- taneous resolution of high grade infantile vesicoureteral reflux. J Urol. 2004 Aug;172(2):694-8; discussion 699.
  • 20. Knudson MJ, Austin JC, McMillan ZM, Hawtrey CE, Cooper CS. Predictive factors of early spontaneous resolution in children with primary vesicoureteral reflux. J Urol. 2007 Oct;178(4 Pt 2):1684-8.
  • 21. McMillan ZM, Austin JC, Knudson MJ, Hawtrey CE, Cooper CS. Bladder volume at onset of reflux on initial cystogram pre- dicts spontaneous resolution. J Urol. 2006 Oct;176(4 Pt 2):1838- 41.
  • 22. McLaren CJ, Simpson ET. Vesico-ureteric reflux in the young in- fant with follow-up direct radionuclide cystograms: the medical and surgical outcome at 5 years old. BJU Int 2002; 90(7):721e4.
  • 23. Mozley PD, Heyman S, Duckett JW, Turek P, Snyder H, Maislin G, et al. Direct vesicoureteral scintigraphy: quantifying early outcome predictors in children with primary reflux. J Nucl Med 1994;35(10):1602e8.
  • 24. Shaikh N, Ewing AL, Bhatnagar S, Hoberman A. Risk of re- nal scarring in children with a first urinary tract infection: a systematic review. Pediatrics. 2010 Dec;126(6):1084-91.
  • 25. Faust WC, Diaz M, Pohl HG. Incidence of post-pyelonephritic renal scarring: a meta-analysis of the dimercapto-succinic acid literature. J Urol. 2009 Jan;181(1):290-7; discussion 297-8.
  • 26. Arlen AM, Broderick KM, Huen KH, Leong T, Scherz HC, Kirsch AJ. Temporal pattern of vesicoureteral reflux on voiding cystourethrogram correlates with dynamic endoscopic hydrodis- tention grade of ureteral orifice. J Urol. 2014 Nov;192(5):1503-7.
  • 27. Läckgren G, Cooper CS, Neveus T, Kirsch AJ. Management of Vesicoureteral Reflux: What Have We Learned Over the Last 20 Years? Front Pediatr. 2021 Mar 31;9:650326.
  • 28. Melick WF, Brodeur AE, Karellos DN. A suggested classification of ureteral reflux and suggested treatment based on cineradio- graphic findings and simultaneous pressure recordings by means of the strain gauge. J Urol. 1962 Jul;88:35-7.
  • 29. Yousefifard M, Toloui A, Rafiei Alavi SN, Madani Neishaboori A, Ahmadzadeh K, Ghelichkhani P, et al. Contrast-enhanced voiding urosonography, a possible candidate for the diagnosis of vesicoureteral reflux in children and adolescents; a systematic review and meta-analysis. J Pediatr Urol. 2022 Feb;18(1):61-74.
  • 30. Murugapoopathy V, McCusker C, Gupta IR. The pathogenesis and management of renal scarring in children with vesicoureteric reflux and pyelonephritis. Pediatr Nephrol. 2020 Mar;35(3):349- 357.
  • 31. Patterson LT, Strife CF. Acquired versus congenital renal scar- ring after childhood urinary tract infection. J Pediatr. 2000 Jan;136(1):2-4.
  • 32. Bar-Sever Z, Shammas A, Gheisari F, Vali R. Pediatric Nephro- Urology: Overview and Updates in Diuretic Renal Scans and Re- nal Cortical Scintigraphy. Semin Nucl Med. 2022 Jul;52(4):419- 431.
  • 33. Mattoo TK, Thomas R. Routine prophylaxis is not necessary to prevent renal scarring in children with urinary tract infection. Evid Based Med. 2017 Dec;22(6):208.
  • 34. Hewitt IK, Pennesi M, Morello W, Ronfani L, Montini G. Antibiotic Prophylaxis for Urinary Tract Infection-Related Renal Scarring: A Systematic Review. Pediatrics. 2017 May;139(5):e20163145.
  • 35. Mattoo TK, Chesney RW, Greenfield SP, Hoberman A, Keren R, Mathews R, Gravens-Mueller L, Ivanova A, Carpenter MA, Moxey-Mims M, Majd M, Ziessman HA; RIVUR Trial Investi- gators. Renal Scarring in the Randomized Intervention for Chil- dren with Vesicoureteral Reflux (RIVUR) Trial. Clin J Am Soc Nephrol. 2016 Jan 7;11(1):54-61.
APA Demiröz Taşolar S, Sığırcı A, mert doğan g, CENGİZ A, yıldız t, SUBAŞI V, Tabel Y (2022). Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood. , 874 - 878. 10.5455/annalsmedres.2022.03.083
Chicago Demiröz Taşolar Sevgi,Sığırcı Ahmet,mert doğan güleç,CENGİZ ASLINUR,yıldız turan,SUBAŞI VEDAT,Tabel Yılmaz Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood. (2022): 874 - 878. 10.5455/annalsmedres.2022.03.083
MLA Demiröz Taşolar Sevgi,Sığırcı Ahmet,mert doğan güleç,CENGİZ ASLINUR,yıldız turan,SUBAŞI VEDAT,Tabel Yılmaz Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood. , 2022, ss.874 - 878. 10.5455/annalsmedres.2022.03.083
AMA Demiröz Taşolar S,Sığırcı A,mert doğan g,CENGİZ A,yıldız t,SUBAŞI V,Tabel Y Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood. . 2022; 874 - 878. 10.5455/annalsmedres.2022.03.083
Vancouver Demiröz Taşolar S,Sığırcı A,mert doğan g,CENGİZ A,yıldız t,SUBAŞI V,Tabel Y Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood. . 2022; 874 - 878. 10.5455/annalsmedres.2022.03.083
IEEE Demiröz Taşolar S,Sığırcı A,mert doğan g,CENGİZ A,yıldız t,SUBAŞI V,Tabel Y "Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood." , ss.874 - 878, 2022. 10.5455/annalsmedres.2022.03.083
ISNAD Demiröz Taşolar, Sevgi vd. "Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood". (2022), 874-878. https://doi.org/10.5455/annalsmedres.2022.03.083
APA Demiröz Taşolar S, Sığırcı A, mert doğan g, CENGİZ A, yıldız t, SUBAŞI V, Tabel Y (2022). Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood. Annals of Medical Research, 29(8), 874 - 878. 10.5455/annalsmedres.2022.03.083
Chicago Demiröz Taşolar Sevgi,Sığırcı Ahmet,mert doğan güleç,CENGİZ ASLINUR,yıldız turan,SUBAŞI VEDAT,Tabel Yılmaz Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood. Annals of Medical Research 29, no.8 (2022): 874 - 878. 10.5455/annalsmedres.2022.03.083
MLA Demiröz Taşolar Sevgi,Sığırcı Ahmet,mert doğan güleç,CENGİZ ASLINUR,yıldız turan,SUBAŞI VEDAT,Tabel Yılmaz Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood. Annals of Medical Research, vol.29, no.8, 2022, ss.874 - 878. 10.5455/annalsmedres.2022.03.083
AMA Demiröz Taşolar S,Sığırcı A,mert doğan g,CENGİZ A,yıldız t,SUBAŞI V,Tabel Y Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood. Annals of Medical Research. 2022; 29(8): 874 - 878. 10.5455/annalsmedres.2022.03.083
Vancouver Demiröz Taşolar S,Sığırcı A,mert doğan g,CENGİZ A,yıldız t,SUBAŞI V,Tabel Y Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood. Annals of Medical Research. 2022; 29(8): 874 - 878. 10.5455/annalsmedres.2022.03.083
IEEE Demiröz Taşolar S,Sığırcı A,mert doğan g,CENGİZ A,yıldız t,SUBAŞI V,Tabel Y "Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood." Annals of Medical Research, 29, ss.874 - 878, 2022. 10.5455/annalsmedres.2022.03.083
ISNAD Demiröz Taşolar, Sevgi vd. "Evaluation of the relationship of the time of vesicoureteral reflux between renal scar development and endoscopic treatment success in early childhood". Annals of Medical Research 29/8 (2022), 874-878. https://doi.org/10.5455/annalsmedres.2022.03.083