Vesicoureteral reflux and elimination disorders

Area of Science:

• Pediatric Urology
• Elimination Disorders
• Vesico Ureteral Reflux (VUR)

Background:

• Elimination disorders, including pure bladder or combined bladder/bowel issues, complicate Vesico Ureteral Reflux (VUR).
• These disorders increase infectious complication risks, threatening upper urinary tract health.
• Chronic urine residue occurs in specific VUR-associated conditions like megacystis-megaureter or urethral obstructions.

Purpose of the Study:

• To explore the association between elimination disorders and Vesico Ureteral Reflux (VUR).
• To detail the types and diagnostic approaches for VUR-associated elimination disorders.
• To outline management strategies emphasizing the integration of elimination disorder treatment with VUR management.

Main Methods:

• Non-invasive investigations: patient history, voiding charts, four observation test.
• Imaging and functional tests: ultrasound, uroflowmetry.
• Invasive investigations: voiding cystourethrography, urodynamics, video urodynamic studies.

Main Results:

• Elimination disorders significantly worsen VUR prognosis and increase infection risks.
• Diagnosis relies on a combination of non-invasive and invasive urodynamic assessments.
• Effective management involves preventing infections, reducing residual urine, and treating constipation.

Conclusions:

• Addressing elimination disorders is crucial for managing VUR and preventing upper tract damage.
• Integrated treatment of VUR and associated elimination disorders can lead to VUR resolution.
• Perioperative management of elimination disorders is essential when VUR requires surgical intervention.