Treatment Outcomes of Subureteric Injection and Ureteroneocystostomy in Children with Vesicoureteral Reflux

• Main Authors: Serkan Arslan, Mustafa Kucukaydin
• Format: Article
• Language: English
• Published: Modestum Publishing LTD 2016-06-01
• Series: Journal of Clinical and Experimental Investigations
• Subjects: Children; vesicoureteral reflux; reflux nephropathy; subureteric injection
• Online Access: http://jceionline.org/upload/sayi/31/JCEI-01305.pdf

Objective: This study was designed to evaluate patients treated with subureteric injection (STING) and ureteroneo­cystostomy by the Lich-Gregoir technique (LGT) due to vesicoureteral reflux (VUR) in terms of radiologic, scintigraphic images, laboratory findings and bladder functions and determine the effectiveness of both treatment modalities. Methods: A total of 106 patients, who were treated with STING and ureteroneocystostomy between January 2002-2010 were investigated. Patients’ age, gender, complaints at presentation, bladder function impairment, laboratory outcome and radiologic and scintigraphic findings were retrospectively examined. The relationship among VUR grades and pel­vicalyceal ectasia, scars, treatment modalities and outcome were evaluated. Results: Left VUR was found in 68(64%) and right VUR in 38(36%) of the patients. The most common level of VUR was Grade III (42 patients, 40%). Additional urologic pathologies were found in 60 of the 106 of patients (57%). Pelvicalyceal ectasia was found in 44 (42%) and scars were seen in dimercaptosuccinic acid (DMSA) in 54 (51%) of the patients. In total 86 (81%) of 106 patients with VUR recovered completely and 20 (19%) patients with VUR regressed. Conclusion: STING is a good alternative especially for patients with low grade VUR. However, it has some drawbacks, such as requiring a long follow-up period, having a lower rate of success compared to open surgery and being less ef­fective in patients with high grade VUR. Ureteroneocystostomy (LGT) is a method with less morbidity and a high success rate, especially in the treatment of patients with higher grade VUR. J Clin Exp Invest 2016; 7 (2): 168-173