[Obstructive complications of endoscopic treatment of vesicoureteral reflux in children]

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F K Abdulaev, V D Kulaev, V V Nikolaev

    Urologiia (Moscow, Russia : 1999)
    |August 31, 2013
    PubMed

    Insights

    Endoscopic treatment for vesicoureteral reflux (VUR) is contraindicated in children with high-degree reflux and signs of ureteral obstruction. This prevents obstructive hydroureteronephrosis (HUN) and preserves upper urinary tract function.

    Area of Science:

    • Pediatric Urology
    • Surgical Innovation
    • Reflux Management

    Context:

    • Vesicoureteral reflux (VUR) is common in children.
    • Endoscopic treatment is a widely used VUR intervention.
    • Obstructive hydroureteronephrosis (HUN) is a potential complication.

    Purpose:

    • To identify patient selection criteria for VUR endoscopic treatment.
    • To determine contraindications for endoscopic VUR treatment.
    • To prevent obstructive hydroureteronephrosis (HUN) post-VUR treatment.

    Summary:

    • Endoscopic VUR treatment was performed in over 4,000 children (4 months-17 years) from 1991-2011.
    • Obstructive HUN occurred in 0.5% of cases, exclusively in those with IV-degree VUR and pre-existing ureteral obstruction.
    • Radiological signs included flask-shaped juxtavesical ureter extension.

    Impact:

    • Identifies specific patient groups at high risk for obstructive HUN.
    • Contraindicates endoscopic VUR treatment in children with high-degree reflux and ureteral obstruction signs.
    • Highlights the importance of pre-treatment evaluation to avoid iatrogenic complications.

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