Selective endoscopic treatment of the non-refluxing contralateral ureter prevents new contralateral vesicoureteral reflux - Abstract

OBJECTIVE: The objective of this study was to evaluate risk factors for new contralateral vesicoureteral reflux (NCVUR) and to investigate whether assessment of the non-refluxing contralateral ureter (NRCU) by hydrodistention and selective treatment can reduce the incidence of NCVUR.

MATERIALS AND METHODS: From 2001 to 2007, 339 of 841 patients (40%) were treated for unilateral VUR by endoscopic injection. While in the first 267 patients the NRCU was only assessed by hydrodistention but not injected (observation group), NRCUs of the subsequent 72 patients were prophylactically treated if deemed at high risk for NCVUR (H2 or H3) (prophylaxis group).

RESULTS: NCVUR occurred in 30 of 267 patients (11.2%) whose NRCUs were observed. No statistically significant risk factors for NCVUR were found in this group. In the subsequent 72 patients, whose H2 and H3 ureters were selectively injected (N = 56), no cases of NCVUR were seen.

CONCLUSIONS: Prophylactic endoscopic treatment of NRCU H2 and H3 ureters successfully prevented the occurrence of NCVUR.

Written by:
Cerwinka WH, Kaye JD, Leong TL, Elmore JM, Scherz HC, Kirsch AJ.   Are you the author?
Pediatric Urology at Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA 30342, USA.

Reference: J Pediatr Urol. 2011 Dec 14. Epub ahead of print.
doi: 10.1016/j.jpurol.2011.11.013

PubMed Abstract
PMID: 22177779

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