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D A Friedlander, W W Ludwig, J R Jayman, A Akhavan
INTRODUCTION: Endoscopic injection of a bulking agent is a common first-line approach to the treatment of vesicoureteral reflux (VUR). While early outcomes are comparable to open ureteroneocystotomy, 5-25% of children will eventually develop recurrent reflux necessitating repeat injections or open ureteral reimplantation. OBJECTIVE: To determine whether prior endoscopic injection of a bulking agent impacts outcomes of subsequent open ureteral reimplantation. STUDY DESIGN: Using a retrospective cohort design, radiographic and clinical outcomes of open ureteral reimplantation were compared between patients with and without prior endoscopic correction of reflux...
March 1, 2018: Journal of Pediatric Urology
Unsal Ozkuvanci, Muhammet Irfan Donmez, Faruk Ozgor, Akif Erbin, Özge Pasin, Ahmet Yaser Muslumanoglu
INTRODUCTION: Durasphere® EXP (DEXP) is a compound of biocompatible and non-biodegradable particles of zirconium oxide covered with pyrolytic carbon. The aim of this study is to evaluate the durability of off-label use of DEXP in the treatment of primary vesicoureteral reflux in children. MATERIALS AND METHODS: Patients who underwent subureteric injection of DEXP for the correction of primary VUR were retrospectively reviewed . Patients aged >18 years as well as those who had grade-I or -V VUR, anatomic abnormalities (duplicated system, hutch diverticulum), neurogenic bladder or treatment refractory voiding dysfunction were excluded...
March 9, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
William R Boysen, Ardavan Akhavan, Joan Ko, Jonathan S Ellison, Thomas S Lendvay, Jonathan Huang, Michael Garcia-Roig, Andrew Kirsch, Chester J Koh, Marion Schulte, Paul Noh, M Francesca Monn, Benjamin Whittam, Trudy Kawal, Aseem Shukla, Arun Srinivasan, Mohan S Gundeti
BACKGROUND: Robot-assisted laparoscopic extravesical ureteral reimplantation (RALUR-EV) is a minimally invasive alternative to open surgery. We have previously reported retrospective outcomes from our study group, and herein provide an updated prospective analysis with a focus on success rate, surgical technique, and complications among surgeons who have overcome the initial learning curve. OBJECTIVE: To assess the safety and efficacy of RALUR-EV in children, among experienced surgeons...
February 20, 2018: Journal of Pediatric Urology
Herui Wang, Chi Zhang, Xiaowen Wang, Yaru Lian, Bin Guo, Miao Han, Xiaoe Zhang, Xiaoting Zhu, Sixian Xu, Zengli Guo, Yunli Bi, Qian Shen, Xiang Wang, Jiaojiao Liu, Yuan Zhuang, Ting Ni, Hong Xu, Xiaohui Wu
Congenital anomalies of the kidney and urinary tract (CAKUT) are among the most common developmental defects in humans. Despite of several known CAKUT-related loci ( HNF1B , PAX2 , EYA1 , etc.), the genetic etiology of CAKUT remains to be elucidated for most patients. In this study, we report that disruption of the Holliday Junction resolvase gene Gen1 leads to renal agenesis, duplex kidney, hydronephrosis, and vesicoureteral reflux (VUR) in mice. GEN1 interacts with SIX1 and enhances the transcriptional activity of SIX1/EYA1, a key regulatory complex of the GDNF morphogen...
2018: International Journal of Biological Sciences
Hoang-Kim Le, George Chiang
PURPOSE OF REVIEW: Significant variance exists in the management of duplex collecting system ureteroceles (DSU). There is a great spectrum in classification, management, and surgical interventions. The practice of performing bladder level operations for vesicoureteral reflux (VUR) and trigonal anatomic distortion, either after ureterocele puncture or in a single setting, has come into question as to whether all DSU patients require it. In this review, we sought to discuss DSU management trends and the need for bladder reconstruction in these patients, as well as to describe our institution's practices...
February 23, 2018: Current Urology Reports
Yu Bin Kim, Chih Lung Tang, Ja Wook Koo
Purpose: To determine the relationship between vaginal reflux (VR) and urinary tract infection (UTI) in female children aged <36 months. Methods: A single center retrospective study was performed for 191 girls aged <36 months, with a diagnosis of febrile UTI, who underwent a voiding cystourethrography (VCUG) for assessment of vesicoureteral reflux (VUR) at Sanggye Paik Hospital. Fifty-one girls, who underwent VCUG for assessment of congenital hydronephrosis or renal pelvis dilatation, without a UTI, formed the control group...
January 2018: Korean Journal of Pediatrics
Vasileios I Sakalis, Rachel Oliver, Peter J Guy, Melissa C Davies
CONTEXT/OBJECTIVE: Vesico-ureteric reflux(VUR) is a known complication of neuropathic bladder in spinal cord injury(SCI) population. Bulking agents such as Macroplastique are new minimally-invasive treatment option for VUR with good results. The aim of this study is to assess the efficacy of Macroplastique alone or in combination with Botox(BTX-A), in managing VUR in SCI population with presumed healthy bladders and correlate the pre-and post-injection urodynamic findings with the outcome...
February 7, 2018: Journal of Spinal Cord Medicine
S Fuentes, A Gómez-Fraile, I Carrillo-Arroyo, C Tordable-Ojeda, D Cabezalí-Barbancho, F López, A Aransay Bramtot
INTRODUCTION: The short-term results of endoscopic treatment of vesicoureteral reflux (VUR) are excellent. Over time, however, a number of patients have been identified for whom VUR reappeared after being resolved with this technique. The aim of this study was to analyse the factors related to this event. MATERIAL AND METHODS: A retrospective, analytical, case-control study included 395 ureteral units with primary VUR treated successfully at our centre, with a minimum follow-up of 3 years...
January 31, 2018: Actas Urologicas Españolas
Monika Bawa, Ravi Kumar Garg, Vedarth Dash, Prema Menon, K L N Rao
Congenital pouch colon (CPC) is frequently associated with vesicoureteric reflux (VUR). These patients require long-term antibiotic prophylaxis and/or an additional surgical intervention for the management of the refluxing system. We propose a single-stage alternative approach in these patients. Two patients diagnosed to have CPC underwent pouch excision and an end colostomy at birth. Further evaluation revealed high-grade reflux in both the patients. At 6 months of age, definitive abdominoperineal pull-through (APPT) surgery along with extravesical detrusorrhaphy was performed...
January 2018: Journal of Indian Association of Pediatric Surgeons
Tuo Deng, Bing Liu, Lianmin Luo, Xiaolu Duan, Chao Cai, Zhijian Zhao, Wei Zhu, Wenqi Wu, Guohua Zeng
OBJECTIVE: To compare the efficacy and safety of robot-assisted laparoscopic ureteral reimplantation (RALUR) and open ureteral reimplantation (OUR) in treating primary pediatric vesicoureteral reflux (VUR) based on published literature. METHODS: A comprehensive literature search of PubMed, Embase, Cochrane Library, CBM, CNKI and VIP databases was conducted to identify studies comparing the outcomes of RALUR with OUR for treating primary pediatric VUR. The last search was in January 2017...
January 27, 2018: World Journal of Urology
Biljana Bazić-Đorović, Marija Radulović, Marija Šišić, Ljiljana Jauković, Sanja Dugonjić, Dragan Pucar, Zoran Janković, Slobodanka Beatović, Milica Janković, Zoran Krstić, Boris Ajdinović
OBJECTIVE: The purpose of this study was to evaluate damage of the kidney with technetium-99m-dimercaptosuccinic acid (99mTc-DMSA) scintigraphy in children with congenital hydronephrosis (CH) and the influence of other postnatal associated diagnoses on abnormal 99mTc-DMSA findings. SUBJECTS AND METHODS: 99mTc-DMSA scintigraphy in 54 children (17 girls and 37 boys), aged from 2 months to 5 years (median 11 months) with 66 congenital hydronephrotic renal units (RU) (42 unilateral hydronephrosis-29 boys and 13 girls; 12 bilateral hydronephrosis-8 boys and 4 girls) was performed...
September 2017: Hellenic Journal of Nuclear Medicine
Jung Won Lee, Sun Mi Her, Ji Hong Kim, Keum Hwa Lee, Michael Eisenhut, Se Jin Park, Jae Il Shin
BACKGROUND: D-dimer, as well as other biomarkers related to coagulation, is significantly increased during severe bacterial infection and sepsis. The aim of this study was to evaluate the usefulness of serum D-dimer as a biological marker in diagnosing acute pyelonephritis (APN) and in predicting vesicoureteric reflux (VUR) in infants with urinary tract infection (UTI). METHODS: We retrospectively analyzed the data of 177 young infants (<2 years) with febrile UTI between 2005 and 2014, grouped as APN and lower UTI groups...
January 6, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Kenneth L Y Chung, Jennifer Sihoe, Kelvin Liu, Nicholas Chao, Judy Hung, Clarence Liu, Felix Yam, Yvonne Leung, Peter Tam, Kim Hung Lee, Michael Leung
OBJECTIVE: Vesicoureteral reflux (VUR) is a common condition associated with childhood urinary tract infection (UTI), which may lead to chronic renal failure and hypertension. Different antireflux approaches were advocated with differences in morbidity and success. The aim of this study is to review and analyze the surgical outcomes of pneumovesicoscopic ureteral reimplantation and endoscopic injection of dextranomer/hyaluronic acid (Dx/HA) in three tertiary centers. MATERIALS AND METHODS: The medical records of 215 patients (159 boys and 56 girls) for a total of 323 ureters underwent surgical interventions for primary VUR from February 2002 to August 2014 were reviewed...
December 22, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ciro Esposito, Lorenzo Masieri, Henri Steyaert, Maria Escolino, Raffaele Cerchione, Angela La Manna, Chiara Cini, Thomas S Lendvay
PURPOSE: This multicentric international retrospective study aimed to report the outcome of robot-assisted extravesical ureteral reimplantation (REVUR) in patients with unilateral vesico-ureteral reflux (VUR). METHODS: The medical records of 55 patients (35 girls, 20 boys) underwent REVUR in four international centers of pediatric robotic surgery for primary unilateral VUR were retrospectively reviewed. Patients' average age was 4.9 years. The preoperative grade of reflux was III in 12...
December 16, 2017: World Journal of Urology
N Capozza, C Gulia, Z Heidari Bateni, A Zangari, S Gigli, V Briganti, S Tursini, C J Koh, M Gaffi, S Baldassarra, F Signore, A Porrello, R Piergentili
OBJECTIVE: Vesicoureteral reflux (VUR) affects up to 1% of Caucasian children. Primary VUR is characterized by failure of the ureterovesicular junction to prevent urine from traveling in a retrograde fashion from the bladder to the ureters and the kidneys. Several reports in the literature describe the prevalence of this condition in pediatric patients; overall, VUR affects more males during infancy and with higher grades. However, a thorough consideration of these articles reveals important contradictions regarding the prevalence by gender and age...
December 2017: European Review for Medical and Pharmacological Sciences
Dustin D Flannery, Erik Brandsma, Judy Saslow, Amy B Mackley, David A Paul, Zubair H Aghai
OBJECTIVE: To determine if infants diagnosed with urinary tract infection (UTI) in the neonatal intensive care unit (NICU) require a routine voiding cystourethrogram (VCUG). STUDY DESIGN: Retrospective data analysis from three centers for infants admitted to the NICU born between 2000 and 2013 and diagnosed with UTI. RESULTS: One hundred twenty-six infants from three centers were diagnosed with UTI during their hospitalization. Renal ultrasound (RUS) was performed in 115 infants (91...
December 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
Yutaka Hayashi, Emi Nishimura, Satoko Shimizu, Go Miyano, Manabu Okawada, Itsuro Nagae, Geoffrey J Lane, Kenji Katsumata, Atsuyuki Yamataka, Akihiko Tsuchida
BACKGROUND/PURPOSE: We report the current status of patients who underwent augmentation cystoplasty (AC) at least 20years previously. METHODS: Surgical history, incidence of urinary tract infection (UTI) and bladder stones, vesicoureteral reflux (VUR), urine cytology, renal function, a colon cancer tumor marker (carcinoembryonic antigen: CEA), and patient outcomes were assessed. RESULTS: Forty patients who underwent AC (mean age: 34.4years; mean follow-up time: 24...
December 2017: Journal of Pediatric Surgery
Manabu Okawada, Hiroshi Murakami, Nana Tanaka, Yuki Ogasawara, Geoffrey J Lane, Tadaharu Okazaki, Toshihiro Yanai, Masahiko Urao, Atsuyuki Yamataka
AIM: The purpose of this study was to determine the incidence of ureteric obstruction (UB) and requirement for Cohen antireflux surgery (CAS) after DefluxⓇ treatment (DT) for vesicoureteric reflux (VUR). METHODS: Between 2011 and 2017, 494 ureters (VUR severity ≤ grade III: N=291 or >grade IV: N=203) were treated by DT at a mean age of 4.5 (range: 0.2-24) years. Epidural Catheter Assistance (ECA) was used to exclude UB by injecting diluted indigo carmine solution (1-3mL) into an epidural catheter inserted into a ureter after DT and confirming dye flow within 15min...
February 2018: Journal of Pediatric Surgery
Ashish Khanna, Ravimohan Suryanarayana Mavuduru, Girdhar S Bora, Sudheer K Devana, Arup K Mandal
We describe the imaging findings of a 19-year-old female patient who presented with recurrent urinary tract infections and pain abdomen which was diagnosed to be due to a left-sided focal segmental megaureter with a calculus. The highlights of the case are functioning moiety with no other associated anomalies like vesicoureteral reflux, Duplex system, and so on.
December 1, 2017: Urology
Zhan Tao Wang, Elias Wehbi, Yasaman Alam, Antoine Khoury
PURPOSE: The RIVUR trial showed a 50% reduction in the risk for urinary tract infection (UTI) recurrence in children receiving continuous antibiotic prophylaxis (CAP). We reanalyzed the RIVUR data with the purpose of using a risk classification system to identify children who are more likely to benefit from CAP. METHODS: Data from 607 children enrolled in the RIVUR trial were obtained from the NIDDK central repository and were analyzed. We stratified these children into low and high-risk categories...
November 30, 2017: Journal of Urology
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