Endoscopic and Conservative Treatment of Vesicoureteric Reflux

Overview

Background.
The aim of study is to evaluate the results of endoscopic treatment of vesicoureteric reflux (VUR) comparing with conservative mode. 

Methods and Results.
In the years 2003–2006 there were forty for children in prospective randomised study enrolled and divided into two groups. Twenty two children 1–40 months old ( 22,9 months) were operated. Dx/Ha (Deflux^®) was instilled for VUR grade 3–5. The results of treatment were compared with outcome of twenty two conservatively treated randomly assigned children aged 1–32 months (mean age 13.5 months) Postoperative videourodynamic study was used to evaluate for the presence of VUR and function of the bladder and ultrasound investigation was performed too (exclusion of obstructive megaureter in operated group). There were 22 children controled after instillation. The children were followed 11–24 months. VUR was cured in 12 cases (54.5 %) and improved (grade 1–2) in 5 children (66,7 %). All children absolved treatment without any complications, excluding one case with obstructive megaureter after pyelonephritis diagnosed. There were 22 children evaluated in conservative group. Five children were cured (22.7 %) and VUR was improved (grade 1–2) in four (18.2 %). 

Conclusions.
Endoscopic miniinvasive instillation of dextranomer is safe and effective treatment of VUR in all age groups with good therapeutical outcome and minimum of adverse effects. 

Key words:
Vesicoureteral reflux, endoscopic transurethral instillation, antibacterial chemoprofylaxis, Deflux^®.