The effect of well-managed lower urinary tract dysfunction on the success rate of endoscopic subureteric injection for low-moderate vesicoureteral reflux.

Abstract

We aimed to study the presence of lower urinary tract dysfunction (LUTD) and those objective parameters obtained from voiding diary (VD), uroflowmetric (UF) and postvoiding residual urine (PVR) and voiding dysfunction symptom score (VDSS) as possible factors effecting the success rate on STING to correct VUR. Children who underwent STING for the first time due to low-moderate (I-III) grade of VUR were evaluated retrospectively. All children diagnosed with VUR were routinely evaluated for LUTD with VD, UF, PVR and VDSS. Children with LUTD were treated with urotherapy and appropriate medical treatment. Each system with VUR was accepted a renal unit and divided into two groups according to the presence of postoperative VUR: Group 1 no VUR, and Group 2 unresolved VUR. Demographic characteristics, DMSA scintigraphy findings, PVR, VDSS and parameters of VD and UF were compared. 80 children (73 (91.3%) girl, 7 (8.8%) boy) with a total of 112 unit were detected. There were 93 (83%) units in group 1 and 19 (17%) in group 2. No difference was observed in voiding frequency and urinary incontinence in VD, flow pattern, maximum flow rate, MBC/EBC maximum bladder capacity/expected bladder capacity in UF, PVR and VDSS between two groups. 21 (26.25%) children were diagnosed and treated for LUTD and STING was successful in 21 (84%) of 25 units. We believe that effectively treated preoperative LUTD provides comparable STING success rate for correcting low- to moderate-grade vesicoureteral reflux (VUR) in the short term.