Skip to main content

Advertisement

SpringerLink
Log in

Early endoscopic injection may prevent new scarring in idiopathic detrusor overactivity disorder with vesicoureteral reflux in children

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Objective

To present baseline characteristics and the long-term treatment results of three groups of patients with idiopathic detrusor overactivity (IDOD) and vesicoureteral reflux (VUR) according to different treatment regimens, which underwent endoscopic subureteric injection (STING) in the early phase of targeted treatment (TT) (ES group), underwent STING in the late phase of TT (LS group) and with TT only (TT group).

Patients and methods

A total of 49 IDOD cases with VUR which were divided into three groups according to treatment regimens were evaluated in terms of age, symptoms, bladder capacities, involuntary contraction pressures (ICP), presence and degree of renal scar, differential renal functions (DF), new scar formation and STING success.

Results

There was no significant difference between the groups in terms of age, side, symptoms, presence of urinary tract infection (UTI), DF, ICP and bladder capacity at diagnosis. A high grade of reflux was found to be significantly lower in the TT group (p = 0.037). There was no significant difference in terms of ICP, DF, bladder capacity and reflux grade between ES and LS Group. But new scar formation was more in LS Group (p = 0.003).

Conclusion

The STING success is satisfactory in IDOD cases with VUR, waiting a long period of time for diminishing symptoms may cost new scar formation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Sillén U (2008) Bladder dysfunction and vesicoureteral reflux. Adv Urol 2008:815472. https://doi.org/10.1155/2008/815472

    Article  PubMed Central  Google Scholar 

  2. Glassberg KI, Combs AJ, Horowitz M (2010) Nonneurogenic voiding disorders in children and adolescents: clinical and videourodynamic findings in 4 specific conditions. J Urol 184:2123–2127. https://doi.org/10.1016/j.juro.2010.07.011

    Article  PubMed  Google Scholar 

  3. Peters CA, Skoog SJ, Arant BS, Copp HL, Elder JS, Hudson RG et al (2010) Summary of the AUA guideline on management of primary vesicoureteral reflux in children. J Urol 184:1134–1144. https://doi.org/10.1016/j.juro.2010.05.065

    Article  PubMed  Google Scholar 

  4. Capozza N, Lais A, Matarazzo E, Nappo S, Patricolo M, Caione P (2002) Influence of voiding dysfunction on the outcome of endoscopic treatment for vesicoureteral reflux. J Urol 168:1695–1698. https://doi.org/10.1097/01.ju.0000027111.84539.f7

    Article  CAS  PubMed  Google Scholar 

  5. Läckgren G, Sköldenberg E, Stenberg A (2007) Endoscopic treatment with stabilized nonanimal hyaluronic acid/dextranomer gel is effective in vesicoureteral reflux associated with bladder dysfunction. J Urol 177:1124–1129. https://doi.org/10.1016/j.juro.2006.10.094

    Article  PubMed  Google Scholar 

  6. Blais AS, Bergeron M, Nadeau G, Ramsay S, Bolduc S (2016) Anticholinergic use in children: persistence and patterns of therapy. Can Urol Assoc J 10(3–4):137–140. https://doi.org/10.5489/cuaj.3527

    Article  PubMed  PubMed Central  Google Scholar 

  7. Van Batavia JP, Nees SN, Fast AM, Combs AJ, Glassberg KI (2014) Outcomes of vesicoureteral reflux in children with nonneurogenic lower urinary tract dysfunction treated with dextranomer/hyaluronic acid copolymer (Deflux). J Pediatr Urol 10(3):482–487

    Article  Google Scholar 

  8. Kraft KH, Molitierno JA, Dewhurst L, Geers C, Gunderson K, Scherz HC et al (2011) Is endoscopic injection therapy a reasonable treatment option for low-grade vesicoureteral reflux in association with overactive bladder? Urology 78(3):675–679. https://doi.org/10.1016/j.urology.2010.12.084

    Article  PubMed  Google Scholar 

  9. Abrams P, Cardozo L, Fall M, Griffiths D, Rosier P, Ulmsten U et al (2002) The standardisation of terminology of lower urinary tract function: report from the Standardisation Subcommittee of the International Continence Society. Am J Obstet Gynecol 187:116–119

    Article  Google Scholar 

  10. Koff SA (1983) Estimating bladder capacity in children. Urology 21:248–252

    Article  CAS  Google Scholar 

  11. Lebowitz RL, Olbing H, Parkkulainen KV, Smellie JM, Tamminen-Möbius TE (1985) International system of radiographic grading of vesicoureteric reflux International Reflux Study in Children. Pediatr Radiol 15:105. https://doi.org/10.1007/BF02388714

    Article  CAS  PubMed  Google Scholar 

  12. Goldraich I, Goldraich NP, Ramos OL (1983) Classification of reflux nephropathy according to findings at DMSA renal scan. Eur J Pediatr 148:212–218

    Google Scholar 

  13. Lee H, Lee YS, Im YJ, Han SW (2012) Vesicoureteral reflux and bladder dysfunction. Transl Androl Urol 1(3):153–159. https://doi.org/10.3978/j.issn.2223-4683.2012.06.09

    Article  PubMed  PubMed Central  Google Scholar 

  14. Sillen U, Brandstrom P, Jodal U, Holmdahl G, Sandin A, Sjöberg I et al (2010) The Swedish reflux trial in children: V. Bladder dysfunction J Urol 184:298–304

    PubMed  Google Scholar 

  15. Fast AM, Nees SN, Van Batavia JP, Comnbs AJ, Glassberg KI (2013) Outcomes of targeted treatment for vesicoureteral reflux in children nonneurogenic lower urinary tract dysfunction. J Urol 190:1028–1032

    Article  Google Scholar 

  16. Altobelli E, Buscarini M, Nappo SG, Nguyen HT, Caione P (2011) Urodynamics investigation on children with vesicoureteral reflux identifies overactive bladder and poor compliance in those with voiding dysfunction. Pediatr Surg Int 27(5):517–522. https://doi.org/10.1007/s00383-010-2822-z

    Article  PubMed  Google Scholar 

  17. Willemsen J, Nijman RJ (2000) Vesicoureteral reflux and videourodynamic studies: results of a prospective study. Urology 55(6):939–943. https://doi.org/10.1016/s0090-4295(00)00549-5

    Article  CAS  PubMed  Google Scholar 

  18. Ural Z, Ulman I, Avanoglu A (2008) Bladder dynamics and vesicoureteral reflux: factors associated with idiopathic lower urinary tract dysfunction in children. J Urol 179(4):1564–1567

    Article  Google Scholar 

  19. Chung E, Lee D, Gani J, Gillman M, Maher C, Brennan J et al (2018) Position statement: a clinical approach to themanagement of adult non-neurogenioveractive bladder. Med J Aust 208(1):41–45. https://doi.org/10.5694/mja16.01097

    Article  PubMed  Google Scholar 

  20. Franco I (2016) Overactive bladder in children. Nat Rev Urol 13(9):520–532. https://doi.org/10.1038/nrurol.2016.152

    Article  CAS  PubMed  Google Scholar 

  21. Fitzgerald MP, Thom DH, Wassel-Fyr C, Subak L, Brubaker L, Van Den Eeden SK et al (2006) Urinary symptoms predict adult overactive bladder symptoms. J Urol 175(3 Pt 1):989–993. https://doi.org/10.1016/S0022-5347(05)00416-7

    Article  PubMed  PubMed Central  Google Scholar 

  22. Griffiths DJ, Scholtmeijer RJ (1987) Vesicoureteral reflux and lower urinary tract dysfunction: evidence for 2 different reflux/dysfunction complexes. J Urol 137(2):240–244

    Article  CAS  Google Scholar 

  23. Mattoo TK, Chesney RW, Greenfield SP, Hoberman A, Keren R, Mathews R et al (2016) Renal scarring in the randomized intervention for children with vesicoureteral reflux (rivur) trial. Clin J Am Soc Nephrol 11:54–61. https://doi.org/10.2215/CJN.05210515

    Article  CAS  PubMed  Google Scholar 

  24. Acar B, Arıkan I, Germiyanoğlu C, Dallar Y (2009) Influence of high bladder pressure on vesicoureteral reflux and its resolution. Urol Int 82:77–80. https://doi.org/10.1159/00017603

    Article  PubMed  Google Scholar 

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Pediatric Surgery, University of Health Sciences, Dr. Behçet Uz Training and Research Hospital, Izmir, Turkey

    Ayşe Başak Uçan, Kamer Polatdemir & Ayşe Demet Payza

  2. Department of Pediatric Surgery, İzmir Faculty of Medicine, University of Health Sciences, Izmir, Turkey

    Arzu Şencan

  3. İzmir Provincial Directorate of Health Non-Communicable Diseases Unit, Izmir, Turkey

    Gökben Yaslı

  4. Department of Pediatric Nephrology, İzmir Faculty of Medicine, University of Health Sciences, Izmir, Turkey

    Nida Dinçel

Authors
  1. Ayşe Başak Uçan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arzu Şencan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gökben Yaslı
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kamer Polatdemir
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ayşe Demet Payza
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nida Dinçel
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

ABU: study design, data collection, data analysis, writing, editing, gaining ethical approval. AŞ: Writing, editing. GY: statistical analysis. KP: Data collection, searching publish documents. ADP: Data collection. ND: supervision, editing. All authors reviewed and edited the manuscript and approved the final version.

Corresponding author

Correspondence to Ayşe Başak Uçan.

Ethics declarations

Competing interests

The authors declare no competing interests.

Conflict of interest

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Ethical approval

Ethical approval for the study was obtained from SBÜ İzmir Dr. Behçet Uz Children’s Education and Research Hospital Ethics Committee (Approval number: 609- 2021/15–14).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Uçan, A.B., Şencan, A., Yaslı, G. et al. Early endoscopic injection may prevent new scarring in idiopathic detrusor overactivity disorder with vesicoureteral reflux in children. Pediatr Surg Int 38, 1075–1082 (2022). https://doi.org/10.1007/s00383-022-05129-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-022-05129-8

Keywords

Search

Navigation