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Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

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Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

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Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection
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Published on: October 12, 2017

[Primary vesicoureteral reflux].

R Stein1, C Ziesel, P Rubenwolf

  • 1Abteilung Kinderurologie der Urologischen Klinik und Poliklinik, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz. Raimund.Stein@unimedizin-mainz.de

Der Urologe. Ausg. A
|January 9, 2013
PubMed
Summary
This summary is machine-generated.

Vesicoureteral reflux (VUR) management balances preventing renal scars with patient burden. Diagnosis and treatment strategies for VUR are tailored to individual risk factors, including age, reflux severity, and bladder dysfunction.

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Vessel-sparing Excision and Primary Anastomosis
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Published on: October 12, 2017

Vessel-sparing Excision and Primary Anastomosis
08:09

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Published on: January 7, 2019

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Diagnostic Imaging

Context:

  • Vesicoureteral reflux (VUR) discussion includes diagnostic nihilism versus invasive approaches.
  • Preventing renal scarring is the primary goal in VUR management.
  • Distinguishing acquired reflux nephropathy from congenital dysplasia is crucial as only the former is treatable.

Purpose:

  • To review current diagnostic and therapeutic strategies for VUR.
  • To emphasize risk-adapted therapy based on patient factors.
  • To discuss the role of bladder dysfunction as a VUR risk factor.

Summary:

  • Diagnostic methods include voiding cystourethrography (VCUG), urosonography, radionuclide cystography, and MRI.
  • European guidelines recommend VUR screening after the first febrile urinary tract infection (UTI).
  • Risk factors for renal scarring include recurrent UTIs, parenchymal scarring, and dilating reflux; dysfunctional elimination syndrome is also a significant factor.
  • Therapeutic decisions consider age, gender, renal scarring, clinical symptoms, bladder dysfunction, and UTI frequency/severity.
  • Antibacterial prophylaxis and endoscopic therapy are debated alternatives to surveillance or surgery.
  • Open surgical techniques offer the highest success rates for dilating VUR with high renal damage risk.

Impact:

  • Informed clinical decision-making for VUR diagnostics and treatment.
  • Optimized prevention of renal scarring in children with VUR.
  • Improved patient outcomes through tailored, risk-adapted management strategies.