Related Experiment Videos
Vesicoureteral reflux and videourodynamic studies: results of a prospective study
1Department of Paediatric Urology, Erasmus University Rotterdam, Sophia Children's Hospital, Rotterdam, The Netherlands.
Insights
Bladder instability affects children with vesicoureteral reflux (VUR), impacting treatment outcomes. Videourodynamic studies are key for diagnosis, and treating instability can improve conservative VUR management.
Area of Science:
- Pediatric Urology
- Pediatric Nephrology
Background:
- Vesicoureteral reflux (VUR) is a common condition in children.
- Bladder instability is frequently observed in children with VUR.
- Understanding the impact of bladder function on VUR treatment is crucial.
Purpose of the Study:
- To investigate the influence of bladder instability on the management of pediatric VUR.
- To assess the effectiveness of conservative and surgical treatments in children with VUR and varying bladder function.
- To evaluate videourodynamic studies as a diagnostic tool for VUR and bladder instability.
Main Methods:
- A prospective study included 102 children with suspected VUR.
- Videourodynamic studies were performed to assess VUR grade and bladder function.
- Children were followed for over 5 years, receiving either conservative or surgical management.
Main Results:
- Bladder instability was present in 40% of the children studied.
- Conservative treatment success rates were 57% with instability versus 67% without.
- Surgical treatment had a 91% success rate.
- Breakthrough infections were more common in children with bladder instability (34%) compared to those with normal bladder function (18%).
Conclusions:
- Bladder instability is a significant factor in pediatric VUR management.
- Videourodynamic studies are effective for diagnosing VUR and associated bladder dysfunction.
- Treating bladder instability with anticholinergic medication can improve conservative VUR treatment outcomes.
- Pediatric VUR patients with bladder instability experience higher rates of breakthrough urinary tract infections.
Objectives:
To study the influence of bladder instability on the conservative management and surgical treatment of children with vesicoureteral reflux (VUR), 102 children were included in a prospective study.
Methods:
During a 5-year period all children suspected to have VUR underwent a videourodynamic study to determine VUR grade and bladder function. This resulted in a group of 36 boys and 66 girls who were followed up for well over 5 years.
Results:
Bladder instability was found in 41 of 102 children (40%). The 102 children were either treated conservatively or surgically. Of the 77 children who were treated conservatively, bladder instability was found in 35 patients. In the conservatively treated group with bladder instability, reflux resolved in 57%; whereas in those with normal bladder function, reflux resolved in 67%. Of the 25 patients who were treated surgically, the operation was successful in 91%. Breakthrough infections occurred in 22 girls and 3 boys, including 14 of 41 patients with bladder instability (34%) and 11 of 61 patients with normal bladder function (18%).
Conclusions:
Bladder instability is a frequent finding and an important factor in the treatment of children with VUR. To determine if a patient has VUR and bladder instability a videourodynamic study has proved to be an easy and efficient diagnostic tool. When bladder instability is treated with anticholinergic medication, almost the same results can be expected from conservative treatment as from surgical treatment compared to children with a normal bladder function. Breakthrough urinary tract infections occur more often in girls and tend to occur more often in children with bladder instability.