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Published on: October 12, 2017
[Primary vesicoureteral reflux in childhood. The current aspects and future outlook]
F Estornell Moragues1, C Reig Ruiz, C Domínguez Hinarejos
1Sección de Urología Pediátrica, Hospital Infantil La Fe, Valencia, España.
Insights
Innovations in diagnosing and treating vesicoureteral reflux (VUR) are improving patient care. New diagnostic methods enhance understanding of VUR
Area of Science:
- Pediatric Urology
- Nephrology
- Diagnostic Imaging
Context:
- Vesicoureteral reflux (VUR) is a significant condition in pediatric urology.
- Understanding VUR's clinical, diagnostic, and therapeutic aspects is crucial for effective management.
- Recent innovations are reshaping the approach to VUR.
Purpose:
- To review current advancements in vesicoureteral reflux (VUR) management.
- To analyze the impact of innovations on VUR diagnosis and treatment.
- To discuss findings from literature review and urodynamic studies in children with VUR.
Summary:
- Fetal VUR and familial cases are key clinical focus areas.
- Established diagnostic tools include renal scintiscanning, isotope-labelled cystography, and urodynamics.
- Urodynamic studies revealed lower urinary tract dysfunction in 50.8% of pediatric VUR patients; endoscopic treatment is gaining prominence over limited surgical innovations.
Impact:
- New diagnostic methods offer better insights into VUR's natural history.
- These advancements are expected to drive changes in current VUR management protocols.
- Improved understanding facilitates more precise and effective therapeutic strategies for VUR.
Objective:
To discuss the current aspects and the impact of innovations on the clinical, diagnostic and therapeutic aspects of vesicoureteral reflux (VUR).
Methods:
The literature on Medline over the last five years are reviewed and the urodynamic findings in our series of children with VUR are analyzed.
Results:
Fetal VUR and those diagnosed in children with a family history are currently considered to be the most interesting study groups from the clinical perspective. Renal scintiscanning, isotope-labelled cystography and urodynamic evaluation are well-established diagnostic methods that permit selecting the most appropriate treatment for patients with this anomaly. In our experience, 50.8% of the 128 patients in whom a urodynamic study was performed, showed changes in lower urinary tract function. Innovations in open surgery have been scanty and endoscopic treatment is increasingly utilized, although the search continues for the ideal biological material.
Conclusions:
The new diagnostic methods utilized in the evaluation of children with VUR will permit a better understanding of the natural history of this anomaly lead to changes in the protocols that are currently used.
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