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Endoscopic treatment of vesicoureteral reflux: current practice and the need formultifactorial assessment
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery. (Barnkirurgi/Christoffersson)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery. (Barnkirurgi/Christoffersson)
2009 (English)In: Therapeutic Advances in Urology, ISSN 1756-2880, Vol. 1, no 3, 131-141 p.Article in journal (Refereed) Published
Abstract [en]

Vesicoureteral reflux (VUR) affects around 1% of all children. It carries an increased risk of febrile urinary-tract infections (UTIs) and is associated with impaired renal function. Antibiotic prophylaxis is an established approach to managing the condition, but it does not protect against UTI and encourages bacterial resistance. Ureteral re-implantation (open surgery) is a relatively traumatic procedure typically requiring hospitalization, and there is a risk of significant post-treatment complications. Endoscopic treatment with NASHA/Dx gel (Deflux) is minimally invasive, well tolerated and provides cure rates approaching those of open surgery: 8090% in several studies. It has also been shown to be effective in a variety of ‘complicated’ cases. Thus, endoscopic treatment is generally preferable to open surgery and long-term antibiotic prophylaxis. Non-treatment of VUR is being discussed as an alternative option, although this mainly appears suitable for children with low-grade reflux and normal kidneys. A new approach to managing VUR may be considered, with treatment decisions based not only on the grade of reflux but also on factors such as age, sex, renal scarring and bladder dysfunction. Open surgery would be reserved only for use in the 1015% of children notresponding to endoscopic treatment and those with severe ureteral anomalies.

Place, publisher, year, edition, pages
2009. Vol. 1, no 3, 131-141 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-153671DOI: 10.1177/1756287209342731OAI: oai:DiVA.org:uu-153671DiVA: diva2:417428
Note
Ingår i forskargruppen Barnkirurgi/Christoffersson, Uppsala University.Available from: 2011-05-17 Created: 2011-05-17 Last updated: 2011-10-31Bibliographically approved

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Läckgren, GöranStenberg, Arne

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