Research Article
BibTex RIS Cite

Year 2020, Volume: 14 Issue: 4, 310 - 317, 26.06.2020

Doğuş Güney , Hüseyin Tuğrul Tiryaki

https://doi.org/10.12956/tchd.509461

Abstract

References

  • 1. Khoury AE, Bägli DJ. Vesicoureteral reflux. In: Campbell MF, Wein AJ, Kavoussi LR editors. Campbell-Walsh Urology. Philadelphia: Saunders/Elsevier, 2007; 3267-309.
  • 2. Wadie GM, Moriarty KP. The impact of vesicoureteral reflux treatment on the incidence of urinary tract infection. Pediatr Nephrol. 2012; 27: 529-38.
  • 3. Abstracts of the XXI. Annual ESPU (European Society of Paediatric Urology) Congress. April 28-May 1, 2010. Antalya, Turkey. J Pediatr Urol. 2010 Apr; 6 Suppl 1: S19-105.
  • 4. Greenbaum LA, Mesrobian HG. Vesicoureteral reflux. Pediatr Clin North Am. 2006; 53: 413-27.
  • 5. Mattoo TK. Mathews R. Vesicoureteral reflux and renal scarring. In: Avner HD, Harmon WE, Niaudet P, Yoshikawa N, editors. Pediatric Nephrology. 6th ed. Berlin Heidelberg, 2009; 1311-37.
  • 6. Stefanidis CJ, Siomou E. Imaging strategies for vesicoureteral reflux diagnosis. Pediatr Nephrol. 2007; 22: 937-47.
  • 7. Zhang Y, Bailey RR. A long term follow up of adults with reflux nephropathy. N Z Med J. 1995; 108: 142.
  • 8. Wennerström M, Hansson S, Jodal U, Stokland E. Disappearance of vesicoureteral reflux in children. Arch Pediatr Adolesc Med. 1998; 152: 879-83.
  • 9. Jaukovic L, Ajdinovic B, Dopudja M, Krstic Z. Renal scintigraphy in children with vesicoureteral reflux. Indian J Pediatr. 2009; 76: 1023-6.
  • 10. Yeung CK, Godley ML, Dhillon HK, Gordon I, Duffy PG, Ransley PG. The characteristics of primary vesico-ureteric reflux in male and female infants with pre-natal hydronephrosis [abstract]. Br J Urol. 1997; 80: 319.
  • 11. Hannula A, Venhola M, Renko M, et al. Vesicoureteral reflux in children with suspected and proven urinary tract infection. Pediatr Nephrol 2010; 25: 1463-9.
  • 12. Skoog SJ et al. Pediatric vesicoureteral reflux guidelines panel summary report: clinical practice guidelines for screening siblings of children with vesicoureteral reflux and neonates/infants with prenatal hydronephrosis. J Urol. 2010; 184: 1145-51.
  • 13. Ural Z, Ulman I, Avanoglu A. Bladder dynamics and vesicoureteral reflux: factors associated with idiopathic lower urinary tract dysfunction in children. J Urol. 2008; 179: 1564–7.
  • 14. Koff S, Wagner T, Jayanti V. The relationship among dysfunctional elimination syndromes primaryvesicoureteral reflux and urinary tract infections in children. J Urol. 1998; 160: 1019-22.
  • 15. Hong YK, Altobelli E, Borer JG. Urodynamic Abnormalities in Toilet Trained Children With Primary Vesicoureteral Reflux. J Urol. 2011 May; 185(5): 1863-8.
  • 16. Sondgrass W. The impact of treated dysfunctional voiding on the non-surgical management of vesicoureteral reflux. J Urol. 1998; 160: 1823-5.
  • 17. Jequier S, Rousseau O. Sonographic measurements of the normal bladder wall in children. Am J Roentgenol 1987; 149: 563-6.
  • 18. Uluocak N, Erdemir F, Parlaktas BS, et al. Bladder wall thickness in healthy school-aged children. Urology 2007; 69: 763-6.
  • 19. Levin RM, Monson FC, Haugaard N, et al. Genetic and cellular characteristics of bladder outlet obstruction. Urol Clin North Am. 1995; 22: 263-83.
  • 20. Allen TD. Forty years experience with voiding dysfunction. BJU Int. 2003; 92: 15-22.
  • 21. Leonardo CR, Filgueiras MFT, Vasconcelos MM, Roberta Vasconcelos R, Marino VP. Risk factors for renal scarring in children and adolescents with lower urinary tract dysfunction. Pediatr Nephrol. 2007; 22: 1891-6.
  • 22. Soygur T, Arıkan N, Yeşili C, Goğuş O. Relationship among pediatric voiding dysfunction and vesicoureteral reflux and renal scars. Urology. 1999; 54: 905-8.
  • 23. Herndon CDA, McKenna PH. The treatment of dysfunctional elimination decreases urinary tract infections and surgery in children with vesicoureteral reflux. Am Acad of Pediatr Annual Meeting. 2000; 185.
  • 24. Lee MD, Lin CC, Huang FY, Tsai TC, Tsai JD. Screening young childern with urinary tract infection for high grade vesicoureteral reflux with renal ultrasound scanning and tecnetium 99m labeled dimercaptosuccinic acid scanning. J Pediatr. 2009; 154: 797-802.
  • 25. Leroy S, Vantalon S, Larakeb A, Ducou-Le-Pointe H, Bensman A. Vesicoureteral reflux in children with urinary tract infection: comparison of diagnostic accuracy of renal US criteria. Radiology. 2010; 255: 890-8.
  • 26. Fouzas S, Krikelli E, Vassilakos P, Gkentzi D, Papanastasiou DA, Salakos C. DMSA scan for revealing vesicoureteral reflux in young children with urinary tract infection. Pediatrics. 2010; 126: 513-9.
  • 27. Howard RG, Roebuck DJ, Yeung PA, Chan KW, Metreweli C. Vesicoureteral reflux and renal scarring in Chinese Children. Br J Radiol. 2001; 74: 331-4.
  • 28. Zerati Filho M, Calado AA, Barroso U Jr, Amaro JL. Spontaneous resolution rates of vesicoureteral reflux in Brazilian children: a 30-year experience. Int Braz J Urol. 2007; 33: 204-12.
  • 29. Jang HC, Lee KH, Park JS. Primary Vesico-Ureteral Reflux: Comparison of Factors between Infants and Children. Korean J Urol. 2011; 52: 206-9.
  • 30. Koyle MA, Elder JS, Skoog SJ, Mattoo TK, Pohl HG, Reddy PP, et al. Febrile urinary tract infection, vesicoureteral reflux, and renal scarring: current controversises in approach to evaluation. Pediatr Surg Int. 2011; 27: 337-46.
  • 31. Lee JH, Son CH, Lee MS, Park YS. Vesicoureteral reflux increases the risk of renal scars: a study of unilateral reflux. Pediatr Nephrol. 2006; 21: 1281-4.
  • 32. Bensman A, Ulinski T. International Vesicoureteral Reflux Study: unsolved questions remaining. Pediatr Nephrol. 2006; 21: 757-8.
  • 33. Chertin B, Prosolovich K, Aharon S, Nativ O, Halachmi S. Surgical Reimplantation for the Correction of Vesicoureteral Reflux following Failed Endoscopic Injection. Advances in Urology. 2011; Article ID 352716, 5 pages.
  • 34. Oberson C, Boubaker A, Ramseyer P, Meyrat BJ, Frey P. Endoscopic and surgical treatment of vesico-ureteral reflux in children. Comparative long-term follow-up. Swiss Med Wkly. 2007 Aug 25; 137(33-34): 471-5.
  • 35. Hayn MH, Smaldone MC, Ost MC, Docimo SG. Minimally invasive treatment of vesicoureteral reflux. Urologic Clinics of North America. 2008; Vol. 35, p.716.
  • 36. Routh JC, Vandersteen DR, Pfefferle H, Wolpert JJ, Reinberg Y. Single center experience with endoscopic management of vesicoureteral reflux in children. Journal of Urology. 2006; Vol. 175, No. 5, pp. 18-93.
  • 37. Lee EK, Gatti JM, DeMarco RT, Murphy JP. Long-Term Followup of Dextranomer/Hyaluronic Acid Injection for Vesicoureteral Reflux: Late Failure Warrants Continued Followup. J Urol. 2009 April; Vol. 181, 1869-75.
  • 38. K. Saperston, J. Smith, and J. Smith. Endoscopic subureteral injection is not less expensive than outpatient open reimplantation for unilateral vesicoureteral reflux. Journal of Urology. 2008; Vol 180, No. 4, pp. 1626-30
  • 39. Elmore JM, Kirsch AJ, Perez-Brayfield MR. Salvage extravesical ureteral reimplantation after failed endoscopic surgery for vesicoureteral reflux. J Urol. 2006 Sep; 176(3): 1158-60.
  • 40. Falkensammer M.L, Gobet R, Stauffer U.G. To Cohen and Forget? Evaluation of Postoperative Imaging Studies after Transtrigonal Ureteric Reimplantation for Vesicoureteric Reflux in Children. Urol Int. 2008; 81(2): 218-21.

Vezikoüreteral Reflü Hastalarının Cerrahi Tedavi Sonuçları

Year 2020, Volume: 14 Issue: 4, 310 - 317, 26.06.2020

Doğuş Güney , Hüseyin Tuğrul Tiryaki

https://doi.org/10.12956/tchd.509461

Abstract

Giriş:



Vezikoüreteral
reflü (VUR) çocukluk çağında sık görülen bir anomalidir. Amac, VUR nedeni ile
cerrahi olarak tedavi edilen hastalarda demografik, radyolojik verileri, tedavi
yöntemlerini ve tedavi sonuçlarını değerlendirerek komplikasyonları ve başarıyı
etkileyen faktörleri ortaya koymaktır.



Gereç ve Yöntemler:



Çalışmamızda;
2007-2014 yılları VUR nedeni ile tedavi edilen hastalar değerlendirildi. Tanı
yaşı, cinsiyet, başvuru şikâyeti, VUR etiyolojisi ve dereceleri, böbrek
hidronefroz dereceleri, böbrek fonksiyonları, tercih edilen cerrahi tedavi
(endoskopik enjeksiyon – üreteroneosistostomi) yöntemleri, tedavi başarı
oranları ve komplikasyonlar kaydedildi. Hastalar bu parametrelere göre
karşılaştırılarak cerrahi tedavi başarısını etkileyen faktörler değerlendirildi.



Bulgular:



Toplam
276 hastanın (409 böbrek üreter birimi) çoğunluğu (%70,3) kızdı. Hastaların
185’i (%67) primer VUR etiyolojisine sahipti. Bilateral reflü oranı %48’di,
4-5. derece reflü oranı %54,8’di. Erkeklerin yaş ortancası 2,5 yıl, kızların 6
yıldı. Kızlarda mesane duvar kalınlaşmasının daha fazla olduğu görüldü.
Hastaların 220’sine ilk girişim olarak endoskopik subüreterik enjeksiyon (STING),
56’sına ise üreteroneosistostomi yapıldı. STING sonrası iyileşme olmayan 43
hastaya daha sonra üreteroneosistostomi yapıldı. Hidronefroz olmayan veya hafif
olan hastalarda cerrahi başarı oranı %90,2, ciddi hidronefroz olanlarda
%72,3’tü. Yüksek dereceli VUR hastalarında %88, düşük ve orta dereceli VUR’lülerde
%98,3’tü, böbrek fonsiyonu kötü olanlarda bu oran %83, iyi ve orta olanlarda
ise %94’tür. Primer VUR hastalarının başarı oranı sekonder VUR’ye göre yüksek
bulundu (%96-%85). Cerrahi tedavi sonunda mesane duvar kalınlaşmasının %52,2
oranında ve hidronefrozun %21,3 oranında gerilediği tespit edildi. STING
sonrası UNC gerektiren hastaların, sadece STING ile iyileşen hastalara göre
hidronefroz ve VUR dereceleri daha yüksek; renal parankimal incelmeleri daha
fazla ve diferansiye böbrek fonksiyonları daha düşük olarak bulundu.



Tartışma:



VUR daha çok kız çocuklarında görülür. Bir yaş altında,
etkilenen erkek çocuk oranı artmaktadır. Çalışmamızda yüksek
dereceli VUR’lü, diferansiye fonksiyonu düşük ve sekonder VUR etiyolojisine
sahip olan böbrek birimlerinde cerrahi tedavi sonuçlarının daha kötü olduğu
görüldü.

Keywords

vezikoüreteral reflü üreteroneosistostomi

References

  • 1. Khoury AE, Bägli DJ. Vesicoureteral reflux. In: Campbell MF, Wein AJ, Kavoussi LR editors. Campbell-Walsh Urology. Philadelphia: Saunders/Elsevier, 2007; 3267-309.
  • 2. Wadie GM, Moriarty KP. The impact of vesicoureteral reflux treatment on the incidence of urinary tract infection. Pediatr Nephrol. 2012; 27: 529-38.
  • 3. Abstracts of the XXI. Annual ESPU (European Society of Paediatric Urology) Congress. April 28-May 1, 2010. Antalya, Turkey. J Pediatr Urol. 2010 Apr; 6 Suppl 1: S19-105.
  • 4. Greenbaum LA, Mesrobian HG. Vesicoureteral reflux. Pediatr Clin North Am. 2006; 53: 413-27.
  • 5. Mattoo TK. Mathews R. Vesicoureteral reflux and renal scarring. In: Avner HD, Harmon WE, Niaudet P, Yoshikawa N, editors. Pediatric Nephrology. 6th ed. Berlin Heidelberg, 2009; 1311-37.
  • 6. Stefanidis CJ, Siomou E. Imaging strategies for vesicoureteral reflux diagnosis. Pediatr Nephrol. 2007; 22: 937-47.
  • 7. Zhang Y, Bailey RR. A long term follow up of adults with reflux nephropathy. N Z Med J. 1995; 108: 142.
  • 8. Wennerström M, Hansson S, Jodal U, Stokland E. Disappearance of vesicoureteral reflux in children. Arch Pediatr Adolesc Med. 1998; 152: 879-83.
  • 9. Jaukovic L, Ajdinovic B, Dopudja M, Krstic Z. Renal scintigraphy in children with vesicoureteral reflux. Indian J Pediatr. 2009; 76: 1023-6.
  • 10. Yeung CK, Godley ML, Dhillon HK, Gordon I, Duffy PG, Ransley PG. The characteristics of primary vesico-ureteric reflux in male and female infants with pre-natal hydronephrosis [abstract]. Br J Urol. 1997; 80: 319.
  • 11. Hannula A, Venhola M, Renko M, et al. Vesicoureteral reflux in children with suspected and proven urinary tract infection. Pediatr Nephrol 2010; 25: 1463-9.
  • 12. Skoog SJ et al. Pediatric vesicoureteral reflux guidelines panel summary report: clinical practice guidelines for screening siblings of children with vesicoureteral reflux and neonates/infants with prenatal hydronephrosis. J Urol. 2010; 184: 1145-51.
  • 13. Ural Z, Ulman I, Avanoglu A. Bladder dynamics and vesicoureteral reflux: factors associated with idiopathic lower urinary tract dysfunction in children. J Urol. 2008; 179: 1564–7.
  • 14. Koff S, Wagner T, Jayanti V. The relationship among dysfunctional elimination syndromes primaryvesicoureteral reflux and urinary tract infections in children. J Urol. 1998; 160: 1019-22.
  • 15. Hong YK, Altobelli E, Borer JG. Urodynamic Abnormalities in Toilet Trained Children With Primary Vesicoureteral Reflux. J Urol. 2011 May; 185(5): 1863-8.
  • 16. Sondgrass W. The impact of treated dysfunctional voiding on the non-surgical management of vesicoureteral reflux. J Urol. 1998; 160: 1823-5.
  • 17. Jequier S, Rousseau O. Sonographic measurements of the normal bladder wall in children. Am J Roentgenol 1987; 149: 563-6.
  • 18. Uluocak N, Erdemir F, Parlaktas BS, et al. Bladder wall thickness in healthy school-aged children. Urology 2007; 69: 763-6.
  • 19. Levin RM, Monson FC, Haugaard N, et al. Genetic and cellular characteristics of bladder outlet obstruction. Urol Clin North Am. 1995; 22: 263-83.
  • 20. Allen TD. Forty years experience with voiding dysfunction. BJU Int. 2003; 92: 15-22.
  • 21. Leonardo CR, Filgueiras MFT, Vasconcelos MM, Roberta Vasconcelos R, Marino VP. Risk factors for renal scarring in children and adolescents with lower urinary tract dysfunction. Pediatr Nephrol. 2007; 22: 1891-6.
  • 22. Soygur T, Arıkan N, Yeşili C, Goğuş O. Relationship among pediatric voiding dysfunction and vesicoureteral reflux and renal scars. Urology. 1999; 54: 905-8.
  • 23. Herndon CDA, McKenna PH. The treatment of dysfunctional elimination decreases urinary tract infections and surgery in children with vesicoureteral reflux. Am Acad of Pediatr Annual Meeting. 2000; 185.
  • 24. Lee MD, Lin CC, Huang FY, Tsai TC, Tsai JD. Screening young childern with urinary tract infection for high grade vesicoureteral reflux with renal ultrasound scanning and tecnetium 99m labeled dimercaptosuccinic acid scanning. J Pediatr. 2009; 154: 797-802.
  • 25. Leroy S, Vantalon S, Larakeb A, Ducou-Le-Pointe H, Bensman A. Vesicoureteral reflux in children with urinary tract infection: comparison of diagnostic accuracy of renal US criteria. Radiology. 2010; 255: 890-8.
  • 26. Fouzas S, Krikelli E, Vassilakos P, Gkentzi D, Papanastasiou DA, Salakos C. DMSA scan for revealing vesicoureteral reflux in young children with urinary tract infection. Pediatrics. 2010; 126: 513-9.
  • 27. Howard RG, Roebuck DJ, Yeung PA, Chan KW, Metreweli C. Vesicoureteral reflux and renal scarring in Chinese Children. Br J Radiol. 2001; 74: 331-4.
  • 28. Zerati Filho M, Calado AA, Barroso U Jr, Amaro JL. Spontaneous resolution rates of vesicoureteral reflux in Brazilian children: a 30-year experience. Int Braz J Urol. 2007; 33: 204-12.
  • 29. Jang HC, Lee KH, Park JS. Primary Vesico-Ureteral Reflux: Comparison of Factors between Infants and Children. Korean J Urol. 2011; 52: 206-9.
  • 30. Koyle MA, Elder JS, Skoog SJ, Mattoo TK, Pohl HG, Reddy PP, et al. Febrile urinary tract infection, vesicoureteral reflux, and renal scarring: current controversises in approach to evaluation. Pediatr Surg Int. 2011; 27: 337-46.
  • 31. Lee JH, Son CH, Lee MS, Park YS. Vesicoureteral reflux increases the risk of renal scars: a study of unilateral reflux. Pediatr Nephrol. 2006; 21: 1281-4.
  • 32. Bensman A, Ulinski T. International Vesicoureteral Reflux Study: unsolved questions remaining. Pediatr Nephrol. 2006; 21: 757-8.
  • 33. Chertin B, Prosolovich K, Aharon S, Nativ O, Halachmi S. Surgical Reimplantation for the Correction of Vesicoureteral Reflux following Failed Endoscopic Injection. Advances in Urology. 2011; Article ID 352716, 5 pages.
  • 34. Oberson C, Boubaker A, Ramseyer P, Meyrat BJ, Frey P. Endoscopic and surgical treatment of vesico-ureteral reflux in children. Comparative long-term follow-up. Swiss Med Wkly. 2007 Aug 25; 137(33-34): 471-5.
  • 35. Hayn MH, Smaldone MC, Ost MC, Docimo SG. Minimally invasive treatment of vesicoureteral reflux. Urologic Clinics of North America. 2008; Vol. 35, p.716.
  • 36. Routh JC, Vandersteen DR, Pfefferle H, Wolpert JJ, Reinberg Y. Single center experience with endoscopic management of vesicoureteral reflux in children. Journal of Urology. 2006; Vol. 175, No. 5, pp. 18-93.
  • 37. Lee EK, Gatti JM, DeMarco RT, Murphy JP. Long-Term Followup of Dextranomer/Hyaluronic Acid Injection for Vesicoureteral Reflux: Late Failure Warrants Continued Followup. J Urol. 2009 April; Vol. 181, 1869-75.
  • 38. K. Saperston, J. Smith, and J. Smith. Endoscopic subureteral injection is not less expensive than outpatient open reimplantation for unilateral vesicoureteral reflux. Journal of Urology. 2008; Vol 180, No. 4, pp. 1626-30
  • 39. Elmore JM, Kirsch AJ, Perez-Brayfield MR. Salvage extravesical ureteral reimplantation after failed endoscopic surgery for vesicoureteral reflux. J Urol. 2006 Sep; 176(3): 1158-60.
  • 40. Falkensammer M.L, Gobet R, Stauffer U.G. To Cohen and Forget? Evaluation of Postoperative Imaging Studies after Transtrigonal Ureteric Reimplantation for Vesicoureteric Reflux in Children. Urol Int. 2008; 81(2): 218-21.
There are 40 citations in total.

Details

Primary Language Turkish
Subjects Surgery
Journal Section ORIGINAL ARTICLES
Authors

Doğuş Güney 0000-0001-7168-2123

Hüseyin Tuğrul Tiryaki 0000-0002-9544-1137

Publication Date June 26, 2020
Submission Date January 7, 2019
Published in Issue Year 2020 Volume: 14 Issue: 4

Cite

Vancouver Güney D, Tiryaki HT. Vezikoüreteral Reflü Hastalarının Cerrahi Tedavi Sonuçları. Türkiye Çocuk Hast Derg. 2020;14(4):310-7.


The publication language of Turkish Journal of Pediatric Disease is English.


Manuscripts submitted to the Turkish Journal of Pediatric Disease will go through a double-blind peer-review process. Each submission will be reviewed by at least two external, independent peer reviewers who are experts in the field, in order to ensure an unbiased evaluation process. The editorial board will invite an external and independent editor to manage the evaluation processes of manuscripts submitted by editors or by the editorial board members of the journal. The Editor in Chief is the final authority in the decision-making process for all submissions. Articles accepted for publication in the Turkish Journal of Pediatrics are put in the order of publication, with at least 6 original articles in each issue, taking into account the acceptance dates. If the articles sent to the reviewers for evaluation are assessed as a senior for publication by the reviewers, the section editor and the editor considering all aspects (originality, high scientific quality and citation potential), it receives publication priority in addition to the articles assigned for the next issue.


The aim of the Turkish Journal of Pediatrics is to publish high-quality original research articles that will contribute to the international literature in the field of general pediatric health and diseases and its sub-branches. It also publishes editorial opinions, letters to the editor, reviews, case reports, book reviews, comments on previously published articles, meeting and conference proceedings, announcements, and biography. In addition to the field of child health and diseases, the journal also includes articles prepared in fields such as surgery, dentistry, public health, nutrition and dietetics, social services, human genetics, basic sciences, psychology, psychiatry, educational sciences, sociology and nursing, provided that they are related to this field. can be published.