Abstract
Lower urinary tract dysfunction with primary vesicoureteral reflux is recognized as a major risk factor for recurrent urinary tract infection, 1 Dias C.S. Silvia J.M. Diniz J.S. et al. Risk factors for recurrent urinary tract infections in a cohort of patients with primary vesicoureteral reflux. Pediatr Infect Dis J. 2010; 29: 2139-2144 Crossref Scopus (39) Google Scholar as well as for failure of open or endoscopic surgery. The authors outline their experience with endoscopic treatment of vesicoureteral reflux in a select group of children with symptoms of overactive bladder (OAB)—urgency or urge incontinence. All patients were toilet trained at diagnosis and had initially received a course of behavior modification, with anticholinergic medication in some cases, and 10% had failed previous dextranomer (Dx)/hyaluronic acid (HA) injection. Using the hydrodistension injection technique method, the overall success rate was commendable at 83%. The authors injected an 18% greater volume of Dx/HA in those children whose OAB symptoms were ongoing at endoscopic surgery and achieved a marginally greater (+8.7%) success rate, on early postoperative voiding cystourethrogram (VCUG) at 6-12 weeks, compared to those whose OAB symptoms had been eradicated preoperatively. After successful Dx/HA injection, the incidence of urinary tract infection was low, and 40% of the children with preoperative well-controlled OAB returned to normal voiding patterns. Is Endoscopic Injection Therapy a Reasonable Treatment Option for Low-grade Vesicoureteral Reflux in Association With Overactive Bladder?UrologyVol. 78Issue 3PreviewTo assess the clinical outcome of endoscopic injection in children with vesicoureteral reflux (VUR) and concomittant overactive bladder (OAB). Full-Text PDF ReplyUrologyVol. 78Issue 3PreviewWe agree that our study carries some limitations, including the lack of urodynamic data and objective criteria for categorizing the voiding symptoms and overactive bladder (OAB). Given our study's retrospective nature, our analysis was dependent on the information available from the chart review. Full-Text PDF
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