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[Vesico-ureteral reflux and vesico-sphincteral dysfunction in children]
A Savanelli1, M Ascolese, P Larpi
1Clinica Chirurgica Pediatrica - 2. Policlinico, Napoli, Italia.
Summary
Neurologically normal children with vesicoureteral reflux often experience micturition disorders. Medical treatment for dysfunctional voiding can improve reflux evaluation and reduce complications, with 50% of children showing resolution of micturition issues.
Area of Science:
- Pediatric Urology
- Pediatric Nephrology
- Urodynamics
Background:
- Vesicoureteral reflux (VUR) in neurologically normal children frequently co-occurs with micturition disorders.
- Bladder-sphincter dysfunction can lead to high intravesical pressures, potentially distorting the vesicoureteral junction similarly to anastomotic obstruction.
Purpose of the Study:
- To analyze the experience of medical treatment for children with VUR associated with micturition disorders.
- To evaluate the efficacy of medical management in resolving VUR and associated voiding dysfunction.
Main Methods:
- Retrospective analysis of 40 children with VUR and micturition disorders.
- Urodynamic studies were utilized for diagnosis and management planning.
- Medical treatment focused on dysfunctional voiding patterns.
Main Results:
- Vesicoureteral reflux resolved in 25% of cases following medical treatment.
- Micturition disorders resolved in 50% of the treated children.
- Medical management potentially reduces postoperative complications and urinary tract infections.
Conclusions:
- Urodynamic studies are crucial for diagnosing bladder-sphincter dysfunction and guiding therapeutic management.
- Medical treatment of dysfunctional voiding is important for improving outcomes in children with VUR.
- Careful diagnosis and tailored treatment are essential for optimizing results in this patient population.