Is routine voiding cystourethrogram necessary following double hit for primary vesicoureteral reflux?

Journal of Pediatric Urology
Angela M ArlenAndrew J Kirsch

Abstract

Current AUA guidelines recommend voiding cystourethrogram (VCUG) following endoscopic treatment of vesicoureteral reflux (VUR). We evaluated the clinical and radiographic outcomes of children undergoing Double HIT (hydrodistention implantation technique) for primary VUR to determine success rates and the necessity of postoperative VCUG. Children with a history of febrile urinary tract infection (fUTI) undergoing Double HIT for primary VUR between 2009 and 2012 were identified. Patients were prospectively classified as high or low clinical and radiographic risk. Children were categorized as high clinical risk if they had ≥ 3 fUTIs or documented bladder bowel dysfunction (BBD). High radiographic risk included those <2 years of age or with grade 4-5 VUR. Initially, all children underwent postoperative VCUG ("routine" group), while only those with an indication (high radiographic risk or clinical failure) did so during the latter portion of the study ("indicated" group). Clinical success was defined as no postoperative fUTI and radiographic success as negative postoperative VCUG. Average clinical follow-up was 34.7 ± 17.2 months. Two hundred and twenty-two children (198 girls, 24 boys) underwent Double HIT at a mean age of 4.1 ± 2....Continue Reading

References

Mar 1, 2002·European Radiology·Frederica PapadopoulouAnastasia Economou
Dec 2, 2008·Archivos españoles de urología·Wolfgang H CerwinkaAndrew J Kirsch
Jun 24, 2010·The Urologic Clinics of North America·J Christopher Austin, Christopher S Cooper
Mar 14, 2012·Pediatrics·Julian WanUNKNOWN Executive Committee, Section on Urology, American Academy of Pediatrics
Aug 23, 2012·The Journal of Urology·Caleb P NelsonBartley G Cilento

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Citations

Jul 23, 2015·Current Urology Reports·Angela M Arlen, Christopher S Cooper
Jul 14, 2016·F1000Research·Michael L Garcia-Roig, Andrew J Kirsch
Dec 21, 2018·International Journal of Urology : Official Journal of the Japanese Urological Association·Kazuyoshi JohninAkihiro Kawauchi
Jan 24, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Armando J LorenzoJoana Dos Santos
Mar 14, 2020·International Braz J Urol : Official Journal of the Brazilian Society of Urology·Andrew J Kirsch, Angela M Arlen
Aug 30, 2016·Current Treatment Options in Pediatrics·Derrick L JohnstonDavid S Hains
Apr 20, 2021·Frontiers in Pediatrics·Göran LäckgrenAndrew J Kirsch
Aug 21, 2021·Seminars in Pediatric Surgery·Angela M Arlen, Andrew J Kirsch

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