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https://www.readbyqxmd.com/read/28941917/national-trends-in-the-management-of-primary-vesicoureteral-reflux-in-children
#1
Michael Garcia-Roig, Curtis Tavers, Courtney E McCracken, Andrew J Kirsch
OBJECTIVE: In September 2011, the American Academy of Pediatrics(AAP) released updated guidelines for workup of children 2-24 months old with a febrile urinary tract infection(UTI). We aimed to document the guideline's impact on diagnosis and surgical management of VUR at US children's hospitals. We hypothesize that VCUG studies and VUR treatment rate decreased concurrent with national guideline release. METHODS: The Pediatric Health Information System(PHIS) was queried for children(<18 years) with primary VUR, and their anti-reflux surgical history, from January 2004-June 2015...
September 20, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28941593/laparoendoscopic-single-site-nephrectomy-in-children-is-it-a-good-alternative-to-conventional-laparoscopic-approach
#2
Belén Aneiros Castro, Daniel Cabezalí Barbancho, Cristina Tordable Ojeda, Isabel Carrillo Arroyo, Jesús Redondo Sedano, Andrés Gómez Fraile
BACKGROUND: Minimally invasive surgery is considered to be the gold standard treatment for nephrectomy in children. In recent decades it has been proposed that laparoendoscopic single-site (LESS) surgery is a feasible alternative to perform laparoscopic nephrectomies. OBJECTIVE: The aim of our study was to compare the safety and efficacy of LESS against conventional laparoscopic (CL) nephrectomy. STUDY DESIGN: From March 2010 to November 2012 charts of pediatric patients who underwent laparoscopic nephrectomy at our tertiary center were revised...
August 24, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28927982/endoscopic-injection-for-primary-vesicoureteric-reflux-predictors-of-resolution-and-long-term-efficacy
#3
Ling Leung, Ivy Hau Yee Chan, Patrick Ho Yu Chung, Lawrence Chuen Leung Lan, Paul Kwong Hang Tam, Kenneth Kak Yuen Wong
AIM: We investigated the efficacy of endoscopic-Deflux-injection in treating primary-vesicoureteric-reflux (VUR) and identified factors to predict resolution. MATERIALS AND METHODS: Records of children treated with Deflux for primary-VUR from 1995 to 2016 were reviewed, and outcomes were investigated. RESULTS: Eighty-eight ureters (35 bilateral, 18 unilateral) in 53 children underwent 124 injections. Thirty-five (66%) patients had single injection (13 unilateral, 22 bilateral)...
September 4, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28918954/contemporary-management-of-vesicoureteral-reflux
#4
REVIEW
Perviz Hajiyev, Berk Burgu
CONTEXT: Vesicoureteral reflux (VUR) remains the most interesting topic of pediatric urology due to the dynamic nature of recent controversial publications. Starting from the need for a diagnosis to the necessity and effectiveness of treatment in preventing scars, VUR remains in the mist. Although recent strong evidence helped as fog lights in this blurriness, more data are required for achieving crystal clearance. This article aims to summarize and discuss the current state of the evidence regarding VUR management...
September 11, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28867581/high-pressure-balloon-dilatation-of-the-ureterovesical-junction-in-primary-obstructive-megaureter-infectious-morbidity
#5
I Kassite, K Braïk, B Morel, T Villemagne, C Szwarc, Z Maakaroun, A R Cook, H Lardy, A Binet
INTRODUCTION: The objective of this study is to investigate the infectious morbidity associated with high-pressure balloon dilatation (HPBD) and an indwelling double J stent, in primary obstructive megaureter. METHODS: We reviewed the cases of 12 patients undergoing endoscopic treatment for primary obstructive megaureter from January 2012 to January 2015. The characteristics of the infection and data concerning the patient and the intervention were analyzed. RESULTS: The frequency of preoperative urinary tract infection (UTI) was 58%...
August 31, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28848728/decreased-identification-of-vesicoureteral-reflux-a-cautionary-tale
#6
Aslam Hyder Qureshi, Oluwaseun Ajayi, Andrew Lawrence Schwaderer, David S Hains
AIM: To find the trend in patient's visits to our centers for vesicoureteral reflux (VUR). We hypothesize that VUR diagnosis and hence possible nephropathy recognition may be diminishing because of changing practice patterns. METHODS: Data were extracted from electronic medical records for new and follow-up patients aged 0-18 years with ICD-9/10 codes to correspond with VUR, VUR unilateral, VUR bilateral, and VUR with reflux nephropathy, as well as new patients with diagnoses of urinary tract infections (UTI) and pyelonephritis at two major pediatric centers from 2012 to 2015...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28834044/urological-complications-following-unstented-pediatric-renal-transplantation
#7
Patrick Opoku Manu Maison, Shaun Smit, Mignon McCulloch, Priya Gajjar, Peter Nourse, Dave Thomson, Elmi Muller, Alastair Millar, Alp Numanoglu, Delawir Kahn, John Lazarus
Urological complications which develop post-renal transplantation can be associated with significant morbidity especially in children. We evaluated the occurrence and management of all urological complications in a series of unstented pediatric renal transplants in a tertiary pediatric hospital. We reviewed the medical records of children who underwent unstented renal transplant between January 1996 and December 2014. Postoperative urological complications and the outcomes of their management were analyzed...
August 20, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28818534/endoscopic-treatment-of-vesicoureteral-reflux-in-infants-can-we-do-it-and-should-we-do-it
#8
Sara Fuentes, Andrés Gómez-Fraile, Isabel Carrillo-Arroyo, Cristina Tordable-Ojeda, Daniel Cabezalí-Barbancho
OBJECTIVE: To evaluate the outcomes of endoscopic treatment of vesicoureteral reflux (VUR) performed on infants, and to discuss the possible role of this approach in selected cases. MATERIAL AND METHODS: A retrospective analysis was conducted on the patients who underwent endoscopic injection of a bulking substance for VUR in our institution, and a comparison was made with patients treated during infancy and those treated later in life. RESULTS: A total of 463 ureteral units were included (296 children), of whom 47 were patients less than 1 year of age (infants, INF group); the remaining 416 were included in a second group (children, CHL)...
August 14, 2017: Urology
https://www.readbyqxmd.com/read/28814707/-transurethral-injection-using-deflux-for-vesicoureteral-reflux-in-three-adult-women-with-frequent-febrile-urinary-tract-infections
#9
Yoko Saito, Jun-Ichi Teranishi, Yohei Kumano, Masahiro Yasui, Syohei Mori, Shuko Yoneyama, Ayako Gobara, Takashi Kawahara, Hiroji Uemura
We report three patients with frequent febrile urinary tract infections (fUTI) who underwent transurethral injection therapy with Deflux for vesicoureteral reflux (VUR). The first case was in a 52-yearold woman who was initially diagnosed with right grade II and left grade I VUR at 18 years of age. She frequently experienced fUTI due to VUR. The second case was in a 29-year-old woman. At age 23,she was diagnosed with right grade III VUR when she developed fUTI. After that,she repeatedly developed fUTI. The third case was in a 40-year-old woman who had frequently experienced fUTI since 25 years of age and had gradually become antibiotics-resistant...
July 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28755057/feasibility-of-superb-microvascular-imaging-to-detect-high-grade-vesicoureteral-reflux-in-children-with-urinary-tract-infection
#10
Hee Kyung Kim, Sara O'Hara, Bo-Kyung Je, Steven J Kraus, Paul Horn
OBJECTIVE: To evaluate superb microvascular imaging (SMI) for the detection of high-grade vesicoureteral reflux (VUR). METHODS: We reviewed the patients with urinary tract infection who underwent renal US with SMI and VCUG. The subjects were divided into a VUR group, which included 17 patients (20 kidney units, KU) with high-grade reflux (grade 4 or 5) on VCUG, and a group without VUR including the same numbers of subjects. The direction of urine movement at the distal ureter and the renal pelvis was reviewed on SMI...
July 28, 2017: European Radiology
https://www.readbyqxmd.com/read/28748898/unilateral-multicystic-renal-dysplasia-prenatal-diagnosis-on-ultrasound
#11
Vaidehi K Pandya, Harsh C Sutariya
Multicystic renal dysplasia (MCRD) is the most common cause of abnormally enlarged kidney, diagnosed on antenatal ultrasound examination. It is an abnormality of the embryonic development in which the renal parenchyma is substituted by nonfunctioning renal tissue made up of cysts which do not communicate with each other. Vesicoureteric reflux (VUR), pelviureteric junction obstruction, vesicoureteric junction obstruction, and ureterocele are the most commonly seen abnormalities in contralateral kidney. Here, we report a case of prenatal diagnosis of unilateral MCRD with VUR in contralateral kidney...
July 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28743527/effectiveness-and-complications-of-augmentation-cystoplasty-with-or-without-non-refluxing-ureteral-reimplantation-in-adult-patients-with-long-standing-bladder-dysfunction-a-single-center-11-year-experience-in-173-cases
#12
Zhaoxia Wang, Limin Liao
PURPOSE: To review our experience for effectiveness and complications of augmentation cystoplasty (AC) with or without non-refluxing ureteral reimplantation in adult patients with long-standing bladder dysfunction MATERIAL AND METHODS: We retrospectively reviewed 173 patients who underwent AC with or without ureteral re-implantation (UR) at our center from July 2005 to July 2016. Clinical data, magnetic resonance urography (MRU), and video-urodynamics (VUD) parameters were collected. The upper urinary tract dilation (UUTD) and vesicoureteral reflux (VUR) grading systems were used to evaluate upper urinary tract function...
July 22, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28737866/algorithms-imaging-tests-comparison-following-the-first-febrile-urinary-tract-infection-in-children
#13
María M Tombesi, Laura F Alconcher, Lucas Lucarelli, Agustina Ciccioli
OBJETIVES: To compare the diagnostic sensitivity, costs and radiation doses of imaging tests algorithms developed by the Argentine Society of Pediatrics in 2003 and 2015, against British and American guidelines after the first febrile urinary tract infection (UTI). POPULATION AND METHODS: Inclusion criteria: children ≤ 2 years old with their first febrile UTI and normal ultrasound, voiding cystourethrography and dimercaptosuccinic acid scintigraphy, according to the algorithm established by the Argentine Society of Pediatrics in 2003, treated between 2003 and 2010...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28710643/-vesicoureteral-reflux-watchful-waiting-surgery-or-antibiotic-prophylaxis
#14
REVIEW
A Schröder
Primary vesicoureteral reflux (VUR) is a dynamic disease with several factors influencing its course. Therapeutic options range from watchful waiting to open surgery. Multiple risk factors for the development of pyelonephritis are identified, which then determine the decision for the appropriate treatment option. They include age, gender, history of pyelonephritis and renal scarring, bladder and bowel dysfunction (BBD), circumcision status and parental preference. The use of continuous antibiotic prophylaxis (CAP) is becoming increasingly controversial with antibiotic resistance being a major concern...
July 14, 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28694079/distal-ureteral-diameter-ratio-is-predictive-of-breakthrough-febrile-urinary-tract-infection
#15
Angela M Arlen, Traci Leong, Paul J Guidos, Siobhan E Alexander, Christopher S Cooper
PURPOSE: Distal ureteral diameter ratio is an objective measure that is prognostic of spontaneous resolution of vesicoureteral reflux. Along with likelihood of resolution, improved identification of children at risk for recurrent febrile urinary tract infections may impact management decisions. We evaluated the usefulness of ureteral diameter ratio as a predictive factor for breakthrough febrile urinary tract infections. MATERIALS AND METHODS: Children with primary vesicoureteral reflux and detailed voiding cystourethrogram were identified...
July 8, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28681079/urinary-tract-infection-in-small-children-the-evolution-of-renal-damage-over-time
#16
Svante Swerkersson, Ulf Jodal, Rune Sixt, Eira Stokland, Sverker Hansson
BACKGROUND: Our objective was to analyze the evolution of kidney damage over time in small children with urinary tract infection (UTI) and factors associated with progression of renal damage. METHODS: From a cohort of 1003 children <2 years of age with first-time UTI, a retrospective analysis of 103 children was done. Children were selected because of renal damage at index (99m)Tc-dimercaptosuccinic acid (DMSA) scintigraphy at least 3 months after UTI, and a late DMSA scan was performed after at least 2 years...
July 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28638940/laparoscopic-vesico-ureteral-reimplantation-with-lich-gregoir-approach-in-children-medium-term-results-of-159-renal-units-in-117-children
#17
Victor Soulier, Aure Lien Scalabre, Manuel Lopez, Chi-Ying Li, Sodara Thach, Sophie Vermersch, Franc Ois Varlet
PURPOSE: Vesico-ureteral reflux (VUR) represents one of the most significant risk factors for acute pyelonephritis in children. Surgery is an important part of its management. Laparoscopic ureteric reimplantation using the Lich-Gregoir technique is an option for VUR. The aim of this study is to assess short- and medium-term outcomes of this approach. MATERIALS AND METHODS: This is a retrospective study including all children with VUR treated by laparoscopic extravesical ureteral reimplantation with the Lich-Gregoir technique in University Hospital of Saint-Etienne from August 2007 to May 2016...
June 21, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28631915/-multispiral-computer-tomography-in-differential-diagnosis-of-congenital-uretheroidhydronefrosis-in-children
#18
E B Khakkulov, Zh U Khusankhodzhaev
AIM: To identify the characteristic MSCT signs of pediatric ureterohydronephrosis allowing to assess the disease severity and differentiate between its various forms. MATERIAL AND METHODS: Sixty five children with III-IV grade ureterohydronephrosis underwent a comprehensive examination including MSCT urography. The study comprised 40 (61.5%) boys and 25 (38.5%) girls aged 3 months to 14 years (mean age 4.15+/-3.21 years). RESULTS: Obstructive disease was detected in 38 (58...
June 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/28630017/vesicoureteral-reflux-is-a-phenotype-not-a-disease-a-population-centered-approach-to-pediatric-urinary-tract-infection
#19
REVIEW
Jathin Bandari, Steven G Docimo
We performed a review of the recent literature concerning urinary tract infection (UTI) evaluation and management. In modeling options for management, one overriding conclusion became apparent: in most affected children, the presence of vesicoureteral reflux (VUR) is inconsequential since it has no bearing on optimal management or outcome. In fact, knowing that a child does not have reflux might bias the provider to withhold potentially helpful therapeutic modalities to decrease UTI morbidity, such as antibiotic prophylaxis...
May 22, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28624552/-watering-can-ureterocele-puncture-technique-leads-to-decreased-rates-of-de-novo-vur-and-subsequent-surgery-with-durable-results
#20
Joseph Haddad, Bhalaajee Meenakshi-Sundaram, Nathan Rademaker, Hubert Greger, Christopher Aston, Blake W Palmer, Bradley P Kropp, Dominic Frimberger
OBJECTIVE: To assess the outcomes of 'Watering Can' ureterocele puncture, a technique previously associated with decreased incidence of de novo VUR, as a durable option for management of ureteroceles and to determine the need for subsequent surgery for VUR following 'Watering Can' puncture. MATERIALS AND METHODS: We retrospectively reviewed records of 55 consecutive endoscopic ureterocele procedures done at our institution from 1999 to 2015. The WCP was performed using a holmium laser fiber to make 10-20 puncture holes through the ureterocele...
June 14, 2017: Urology
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