[Treatment of vesico-ureteral reflux in low compliance bladder]

Ten patients with noncompliant bladders and vesicoureteral reflux who did not respond to I.C. and anticholinergic therapy, underwent bladder augmentation and no effort was made to correct reflux surgically, because in these patients, in theory, reflux is secondary to bladder dysfunction. In 8 patients bladder augmentation was made with the intestine and in 2 with the ureter. All patients had a normal compliance after treatment and of the 10 patients with reflux (14 renal units) it disappeared in 7 (11 renal units) and in the 90% of the patients with grades III and IV. In the 3 patients where reflux remained, in 2 it was a unilateral low grade reflux (II) and in 1, had improvement from grade IV to grade II. In these patients reflux only appearing when the bladder got too full, which under normal conditions patients do not get with the I.C. Our experience indicates the antireflux procedures are not routinely needed in this group of patients.