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Sympathoadrenal function in patients with vesicoureteral reflux and neuropathic bladder
Author(s) -
Milovanov Svyatoslav S.,
Derugina Ludmila A.,
Uts Irina A.
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a497
Subject(s) - vesicoureteral reflux , medicine , reflux , urology , bladder augmentation , urinary system , urinary bladder , disease
Hypothesis: If high pressure is responsible for vesicoureteral reflux in neurogenic bladders, eliminating the high pressure should resolve reflux in noncompliant bladders. High pressure could be the result of sympathoadrenal activation because of the dopamine treatment in the early childhood. Materials and Methods: Bladder augmentation was performed in 16 boys and 26 girls with a noncompliant bladder and vesicoureteral reflux at a mean age of 10 years (range 2 to 15). No effort had been made to correct reflux surgically in these patients. Results: After bladder augmentation bladder compliance improved in all patients. Of the 16 ureters with high grade reflux 2 were used for bladder augmentation, and reflux resolved in 13, was downgraded in 1 and persisted in 2. Of the 4 ureters with low grade reflux, reflux disappeared in 2 and was down graded in 2. The rate of high and low grade vesicoureteral reflux resolution or improvement was 88.0% and 100%, respectively. At the end of the study only 3 patients had persistent reflux, which was downgraded in 2. No urinary tract infections developed in any patient. Conclusions: Our experience indicates that antireflux procedures are not routinely needed in patients with a noncompliant bladder and associated vesicoureteral reflux who undergo bladder augmentation. Vesicoureteral reflux might reflex the result of high pressure due to simpatoadrenal activation [Support was provided by grants of Russian Federation].