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Efficacy of endoscopic subureteral injection for vesicoureteral reflux in adults with decreased bladder compliance
Author(s) -
Lee Kyu Sung,
Han Deok Hyun,
Jeong Jae Yong,
Lee Young Suk,
Ko Jae Wook
Publication year - 2010
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2010.02545.x
Subject(s) - medicine , vesicoureteral reflux , reflux , voiding cystourethrogram , urology , cystometry , nephrology , endoscopic treatment , urinary system , ureter , compliance (psychology) , medical record , surgery , endoscopy , urinary bladder , disease , psychology , social psychology
Objective: To evaluate the outcome of endoscopic subureteral injection (ESI) in adults with vesicoureteral reflux (VUR) associated with decreased bladder compliance (D‐BC). Methods: We retrospectively reviewed the medical records of 46 consecutive patients who underwent ESI for VUR at a single tertiary academic center. Fourteen patients (17 ureter units) who had underlying neurological disease with decreased bladder compliance, as determined by filling cystometry, were grouped as D‐BC. Thirty‐two patients (47 units) who had no signs or symptoms that suggested neurogenic lower urinary tract dysfunctions were grouped as normal bladder compliance (N‐BC). We compared the cure rates for ESI between groups, defining cure as complete resolution of reflux on voiding cystourethrogram. Results: In 70.6% of the D‐BC group and 70.2% of the N‐BC group, VUR resolved completely after the first injection ( P = 0.977). One failed unit of D‐BC was cured after second ESI, and seven failed units of N‐BC were cured after additional treatments (second ESI, two patients; ureteroneocystostomy, five patients). No additional treatments were applied to three units of D‐BC or seven units of N‐BC without symptoms. No complications related to the ESI were observed. Conclusions: The ESI was found to be effective in adults with VUR regardless of the bladder compliance. As a minimally invasive procedure with a favorable outcome, ESI may represent the first choice for treatment of VUR even in adults with D‐BC.