title: Selective endoscopic treatment of the non-refluxing contralateral ureter prevents new contralateral vesicoureteral reflux.
abstract: OBJECTIVE
  The objective of this study was to evaluate risk factors for new contralateral vesicoureteral reflux (NCVUR) and to investigate whether assessment of the non-refluxing contralateral ureter (NRCU) by hydrodistention and selective treatment can reduce the incidence of NCVUR.
  
  
  METHODS
  From 2001 to 2007, 339 of 841 patients (40%) were treated for unilateral VUR by endoscopic injection. While in the first 267 patients the NRCU was only assessed by hydrodistention but not injected (observation group), NRCUs of the subsequent 72 patients were prophylactically treated if deemed at high risk for NCVUR (H2 or H3) (prophylaxis group).
  
  
  RESULTS
  NCVUR occurred in 30 of 267 patients (11.2%) whose NRCUs were observed. No statistically significant risk factors for NCVUR were found in this group. In the subsequent 72 patients, whose H2 and H3 ureters were selectively injected (N = 56), no cases of NCVUR were seen.
  
  
  CONCLUSIONS
  Prophylactic endoscopic treatment of NRCU H2 and H3 ureters successfully prevented the occurrence of NCVUR.
authors.affiliation: Pediatric Urology at Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA 30342, USA. wcerwinka@gaurology.com
authors.forename: Wolfgang H
authors.initials: WH
authors.lastname: Cerwinka
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Kaye
authors.forename: Traci L
authors.initials: TL
authors.lastname: Leong
authors.forename: James M
authors.initials: JM
authors.lastname: Elmore
authors.forename: Hal C
authors.initials: HC
authors.lastname: Scherz
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Kirsch
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003911:Dextrans / Q000627:therapeutic use*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D015994:Incidence; D007223:Infant; D015552:Injections, Intralesional / Q000379:methods; D008297:Male; D012307:Risk Factors; D055502:Secondary Prevention; D016896:Treatment Outcome; D014513:Ureter; D014718:Vesico-Ureteral Reflux / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D003911:Dextrans; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid