Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S4-14

(P)

VUR TIMING ON VCUG AS PREDICTIVE FACTOR OF VUR RESOLUTION AFTER

ENDOSCOPIC INJECTION

Jun Nyung LEE

, Ji Yong HA

, Hyun Tae KIM

and Sung Kwang CHUNG

1) SCHOOL OF MEDICINE KYUNGPOOK NATIONAL UNIVERSITY, UROLOGY, Daegu, KOREA (REPUBLIC OF) - 2) School of

medicine, Keimyung university, Urology, Daegu, KOREA (REPUBLIC OF)

PURPOSE

In children with vesicoureteral reflux (VUR), the identification of reflux is made during either the filling or voiding phase

of the voiding cystourethrogram (VCUG). The timing of VUR on VCUG is known as a predictive factor of spontaneous

resolution in VUR children. We assess the effect of VUR timing on the radiologic outcome after endoscopic

dextranomer/hyaluronic acid copolymer injection for VUR.

MATERIAL AND METHODS

We retrospectively reviewed the medical records of 94 VUR patients (136 ureters) who underwent endoscopic

dextranomer/hyaluronic acid copolymer injection as initial surgical management at our institution between May 2006

and December 2013. Radiologic success was defined as grade I or less on VCUG at 3-6months after endoscopic

injection. We allocated patients to a filling reflux group or a voiding reflux group on the basis of the most recent

preoperative VCUG. We evaluated patient demographics and outcomes after endoscopic injection according to VUR

timing. Predictive factors for persistent VUR were analyzed in a multivariate logistic regression model.

RESULTS

Of the 94 children (136 ureters), 68 (101 ureters) were allocated to the filling reflux group and 26 (35 ureters) were

allocated to the filling reflux group. Preoperative VUR grade in filling reflux group was significantly higher than that in

voiding reflux group (p = 0.001). The radiologic success was observed 56.44% (57/101 ureteral units) in the filling

reflux group and 88.57% (31/35 ureteral units) in the voiding reflux group (p = 0.001). Multivariate analysis showed

that higher VUR grade (grade≥IV) and filling reflux on VCUG were predictive factors of persistent VUR after endoscopic

surgery (p = 0.001 and p = 0.005).

CONCLUSIONS

VUR timing on preoperative VCUG was found to be an independent predictive factor of VUR resolution after endoscopic

injection. Our findings indicate that VUR timing should be considered a priority in the management of VUR patients who

needed surgical intervention.