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

Year 2016, , 168 - 173, 16.06.2016

Serkan Arslan

https://doi.org/10.5799/ahinjs.01.2016.02.0591

Abstract

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

Keywords

Children, vesicoureteral reflux, reflux nephropathy, subureteric injection

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