EFFICACY OF ENDOSCOPIC TREATMENT FOR PRIMARY VESICO-URETERIC REFLUX IN CHILDREN

Authors

  • Muhammad Athar Khwaja Pakistan Kidney Institute, Shifa International Hospital, Islamabad
  • Gul Nawaz Pakistan Kidney Institute, Shifa International Hospital, Islamabad
  • Muhammad Imran Jamil Pakistan Kidney Institute, Shifa International Hospital, Islamabad
  • Shujah Muhammad Pakistan Kidney Institute, Shifa International Hospital, Islamabad
  • Asad ur Rehman Pakistan Kidney Institute, Shifa International Hospital, Islamabad
  • Durre Shohab Pakistan Kidney Institute, Shifa International Hospital, Islamabad
  • Iftikhar Ali Khan Pakistan Kidney Institute, Shifa International Hospital, Islamabad
  • Ijaz Hussain Pakistan Kidney Institute, Shifa International Hospital, Islamabad
  • Waqas Iqbal Pakistan Kidney Institute, Shifa International Hospital, Islamabad
  • Saeed Akhter Pakistan Kidney Institute, Shifa International Hospital, Islamabad

Abstract

Background: Vesicoureteral reflux (VUR) is a common anomaly affecting 1–3% of all children and 30–50% of those with urinary tract infection (UTI). In the past febrile vesicoureteric reflux on chronic antibiotic prophylaxis were treated by open surgery. Now a day’s endoscopic injection of a bulking material has replaced open surgical procedure in cases of primary VUR. Our objective was to assess the efficacy of endoscopic treatment for primary vesico-ureteric reflux in children. Methods: This was a descriptive case series. One hundred and five patients with either unilateral or bilateral VUR (181ureters) underwent endoscopic treatment for primary VUR between January 2011 and January 2014. Children from 1 to 12 years of age with grade-II to IV reflux on preoperative voiding cystourethrogram (VCUG) were enrolled through consecutive non-probability sampling. Efficacy of treatment was evaluated at three months post injection by a standard VCUG. Ureters with no or grade-I reflux were considered successful treatment. Results: Out of 105 patients 76 had bilateral while 29 had unilateral reflux. Mean age was 5.7 years (SD±.7). Among 181 refluxing ureters, 116 (64%) were free of reflux, while 49 (27%) showed down gradation and 16 (8.8%) showed no response to treatment on postoperative VCUG. Conclusion: Endoscopic treatment for VUR is a viable option for patients with primary VUR and may be considered in management of such cases.

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Published

2015-12-15

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