[Long term results of endoscopic treatment of reflux in hemodialysis patients waiting for transplantation].
Between January 1986 and April 1988, 13 patients (mean age: 35 years) waiting for renal transplantation (mean duration of haemodialysis: 46 months) were treated by means of O'Donnell's technique. Vesico-ureteric reflux was unilateral in 6 patients and bilateral in 7 patients (20 refluxing ureteric units). Reflux was classified as Grade II for 7 ureters, Grade III for 8 ureters and Grade IV for 5 ureters. The volume of Teflon injected ranged from 1 to 4 cm3 and 6 patients received repeated injections. No complications were observed. Complete resolution of reflux was obtained in 9 patients (69%), i.e. 15 ureteric units (75%). Reflux persisted in 4 patients (31%), i.e. 5 ureteric units (25%). Three nephro-ureterectomies were performed in 2 patients with persistent high grade reflux, but 2 patients with Grade I reflux after endoscopic treatment were not operated. All patients were transplanted after endoscopic treatment (mean interval between correction of reflux and transplantation: 13 months) and a follow-up cystography was systematically performed after transplantation (mean follow-up after transplantation: 27 months): no recurrence of the reflux was detected (mean follow-up after endoscopic treatment: 40 months). Endoscopic treatment of reflux avoids the need for nephro-ureterectomy in 80% of haemodialysis patients waiting for renal transplantation and presenting with vesico-ureteric reflux.
Gabriele
S
S
Service Urologie/Transplantation, Hôpital Edouard Herriot, Lyon.
Dawhara
M
M
Maréchal
J M
JM
Martin
X
X
Gelet
A
A
D000283:Administration, Intravesical; D000293:Adolescent; D000328:Adult; D003558:Cystoscopy / Q000379:methods / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000209:etiology / Q000628:therapy; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000008:administration & dosage; D006435:Renal Dialysis; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D014850:Waiting Lists
D011138:Polytetrafluoroethylene
Résultats à long terme du traitement endoscopique du reflux chez les hémodialysés en attente de transplantation.