Endoscopic and surgical treatment of vesico-ureteral reflux in children. Comparative long-term follow-up.
Détails
Etat: Public
Version: Final published version
ID Serval
serval:BIB_B152726FA944
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Endoscopic and surgical treatment of vesico-ureteral reflux in children. Comparative long-term follow-up.
Périodique
Swiss Medical Weekly
ISSN
1424-7860
Statut éditorial
Publié
Date de publication
2007
Peer-reviewed
Oui
Volume
137
Numéro
33-34
Pages
471-475
Langue
anglais
Résumé
PRINCIPLES: This retrospective study analyzes the long-term results of endoscopic and surgical treatment of vesico-ureteral reflux in children. METHODS: A cohort of 130 patients, 67 girls and 63 boys with a mean age of 30 months were treated either by endoscopic subureteral collagen injection (SCIN) in 92 and by Cohen reimplantation surgery in 123 refluxing ureteral units. Mean follow-up was 4.2 years varying from 1 to 8.7 years. Reflux recurrence, urinary tract infection (UTI) and renal function were evaluated. RESULTS: After SCIN reflux was absent in 64% at 6 months. 20% of the initially 92 refluxing ureters were injected twice. After one or two injections reflux was absent in 71%. In 21% recurrent reflux was of grade I or II, not requiring further treatment. UTI was observed in 27%. After Cohen ureteral reimplantation reflux was absent in 96% at 6 months. UTI was observed in 23%. Renal function at diagnosis and follow-up was compared in children with bilateral grade III reflux only. In patients treated with SCIN it was normal in 77% preoperatively and in 90% at follow-up. In patients treated by open surgery it was normal in 47% preoperatively and in 76% at follow-up. CONCLUSION: For high-grade vesico-ureteral reflux re-implantation surgery remains the gold standard. SCIN is indicated for low and medium grade reflux. Recurrent bacteriuria was observed more often after SCIN and pyelonephritis more often after open surgery. The renal function seems to be preserved with both techniques.
Mots-clé
Child, Child, Preschool, Collagen, Cystoscopy, Cystostomy, Female, Follow-Up Studies, Humans, Infant, Injections, Male, Prosthesis Implantation, Retrospective Studies, Time Factors, Treatment Outcome, Ureter, Urodynamics, Urography, Vesico-Ureteral Reflux
Pubmed
Web of science
Création de la notice
28/02/2008 11:25
Dernière modification de la notice
20/08/2019 16:20