Management Of Primary Vesicoureteral Reflux Research Articles

Active surgical management of primary vesicoureteral reflux in adults.

Of 27 adults with primary vesicoureteral reflux, 23 were treated surgically. These patients had suffered from chronic urinary-tract infections with poor response to conservative therapy. Urography revealed inflammatory changes in one or both kidneys in 18 patients, as well as other renal or ureteral deformities. Micturition cystography showed reflux reaching the renal pelvis and dilatation of the pelvis and ureter in 18 patients (28 ureters). An antireflux operation was performed on 32 ureters and in all cases was followed by disappearance of the reflux. No ureteral stricture developed postoperatively. During an observation period averaging more than three years only three patients had postoperative urinary-tract infections. These occurred when a short period of medication was terminated. On the basis of present experience we consider that antireflux surgery is indicated for all adults with vesicoureteral reflux and urinary-tract infections or progressive dilatation of the upper urinary tract.

The Role of Scheduled Voiding in the Management of Primary Vesicoureteral Reflux

The intrammal tunnel shortens as the bladder filis. At any given pressme reflux is more likely to occur when the bladder is full than when it is empty. Therefore, cystoscopic description of the size, shape and position of the ureteral orifices must include a notation regarding the degree of bladder filling. Scheduled voiding is one of the most important adjunctive measures in the non-operative management of primary reflux One of the prime indications for ureteroneocystostomy is the cystoscopic aemonstration of abnormal ureteral orifices at bladder volumes too low to allow a reasonable voiding interval.