Factors involved in the late failure of endoscopic vesicoureteral reflux treatment

Abstract

IntroductionThe short-term results of endoscopic treatment of vesicoureteral reflux (VUR) are excellent. Over time, however, a number of patients have been identified for whom VUR reappeared after being resolved with this technique. The aim of this study was to analyze the factors related to this event. Material and methodsA retrospective, analytical, case–control study included 395 ureteral units with primary VUR treated successfully at our center, with a minimum follow-up of 3 years. We identified cases in which VUR reappeared and analyzed the demographic variables, those related to VUR (grade, laterality, initial study) and those related to the operation (materials used). ResultsWe identified 77 ureteral units with recurrence in the 395 included units (19.5%). The recurrence rate was 29.7% for the patients treated with dextranomer/hyaluronic acid (Dx/HA), 20.2% for those treated with polydimethylsiloxane (MP) and 12.2% for polytetrafluoroethylene (PTFE). The onset of recurrence rose to 35% for patients treated before 1 year of age and those with grade V VUR. Urinary dysfunction symptoms also increased the recurrence rate to 34.9%. ConclusionThe use of resorbable dextranomer/hyaluronic acid material was related to recurrence in the endoscopic treatment of VUR. The high-grade reflux and treatment at an early age, as well as the presence of urinary dysfunction, are also factors associated with recurrence.