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Related Concept Videos

Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

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Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
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Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

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Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
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Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

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Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
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Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

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Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
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Gastroesophageal Reflux Disease I: Meaning and Pathophysiology01:29

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Gastroesophageal Reflux Disease (GERD) involves the recurrent backflow of the stomach or duodenal contents into the esophagus, leading to troublesome symptoms and potential esophageal mucosal damage. Although GERD is often referred to as a disease, it is more accurately described as a syndrome, as it encompasses a range of symptoms and complications rather than a singular pathological entity, impacting a large number of individuals as the most prevalent upper gastrointestinal problem. Roughly...
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure...
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[Anti-reflux surgery in infancy: contra].

Wolfgang Rösch1

  • 1Klinik für Kinderurologie in Kooperation mit der Universität Regensburg, KUNO-Kliniken Standort St. Hedwig, Regensburg.

Aktuelle Urologie
|December 5, 2019
PubMed
Summary

Vesicoureteral reflux (VUR) management in infants is debated. Endoscopic VUR treatment in infants is not routinely recommended due to high spontaneous resolution rates and immature bladder function, despite its feasibility.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Surgical Innovation

Background:

  • Vesicoureteral reflux (VUR) management in infants is controversial.
  • High spontaneous resolution rates (up to 45%) and immature bladder function characterize VUR in early life.
  • Renal hypo-/dysplasia in boys is a significant associated condition (up to 30%).

Purpose of the Study:

  • To evaluate the current controversial management of VUR in infants.
  • To assess the role of endoscopic treatment versus conservative management.
  • To analyze outcomes regarding urinary tract infections, renal scarring, and surgical risks.

Main Methods:

  • Review of recent literature on VUR management in infants.
  • Comparison of outcomes between endoscopic treatment and antibiotic prophylaxis.

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  • Consideration of anesthesia, recurrence rates, and obstruction risks with surgical interventions.

    • Main Results:

    • Endoscopic treatment for VUR in infants shows no significant difference in preventing urinary tract infections or renal scarring compared to antibiotic prophylaxis.
    • Minimally invasive anti-reflux surgery is feasible in infants.
    • High spontaneous VUR resolution rates (up to 45%) occur within the first 12-15 months of life.

    Conclusions:

    • Endoscopic VUR treatment should not be a routine intervention in infants.
    • The high rate of spontaneous resolution and immature bladder function in infants necessitate a cautious approach.
    • Management decisions must weigh potential benefits against risks like anesthesia and surgical complications.