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Vesico‐ureteric reflux in adult patients with spinal injury
Author(s) -
FOLEY S.J.,
MCFARLANE J.P.,
SHAH P.J.R.
Publication year - 1997
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1046/j.1464-410x.1997.00191.x
Subject(s) - medicine , incidence (geometry) , etiology , reflux , vesicoureteral reflux , surgery , retrospective cohort study , renal function , disease , physics , optics
Objectives To review the incidence, aetiology, treatment and prognosis of vesico‐ureteric reflux (VUR) in patients in a regional spinal injuries centre. Patients and methods A retrospective review of radiological investigations revealed 34 of 447 (8%) patients with VUR on at least one study. The notes of these patients were examined to determine their management and outcome. Results Most patients developed VUR within 4 years of injury; the underlying intravesical pressure was high in half the patients studied. Patients were managed aggressively with a variety of medical and surgical techniques. The VUR of 15 patients resolved completely and in three patients there was some improvement. Renal function deteriorated in three patients as assessed by isotopic scanning. Two patients were transferred to our unit in end‐stage renal failure associated with VUR and died within one year. Conclusions VUR continues to be a problem in patients with spinal injury and remains potentially fatal through the effects of high transmitted pressure and infection. Renal failure does not always develop as a consequence of the combination of VUR and high intravesical pressure. No single aetiological factor for VUR was found. With active early treatment, the incidence of VUR can be minimized and long‐term complications avoided.