title: The reliability of VCUG performed within 24 hours after injection of dextranomer/hyaluronic acid in patients with vesico-ureteral reflux.
abstract: OBJECTIVE
  To assess the reliability and negative predictive value of voiding cystourethrogram (VCUG) performed within 24 hours postoperatively.
  
  
  METHODS
  Forty patients (56 ureters) who underwent first injection of dextranomer/hyaluronic acid (Dx/HA) because of vesicoureteral reflux (VUR) were enrolled. Patients with previous reflux operation or neurogenic disorders were excluded. All patients underwent the hydrodistention implantation technique (HIT). Patients underwent VCUG within 24 hours postoperatively and after 6 months. Grade 0 and grade 1 were considered to be cured. Negative predictive values of VCUG performed within 24 hours postoperatively were assessed.
  
  
  RESULTS
  The mean age of the patient was 98 ± 45.8 months. Twenty-seven patients were male and 13 patients were female. The number of refluxing ureters was 4, 12, 14, 12, and 14 in ascending order of VUR grade. Overall success rate of single injection therapy was 66.07%. Only 2 ureters with grade IV and 1 patient with grade V VUR showed failure on 24-hour VCUG. The success rates on 6 months VCUG were 100%, 83.3%, 78.57%, 50%, and 42.85% according to ascending order of VUR grade.The negative predictive value of 24-hour VCUG were 100%, 83.3%, 78.57%, 60.0%, and 46.15% according to ascending order of VUR grade. VUR grade was the only factor associated with the discrepancy. Positive but weak correlation was noted between the preoperative grade of VUR and the rate of discrepancy on Spearman correlation analysis (Spearman correlation coefficient = 0.303, P value = .018).
  
  
  CONCLUSIONS
  Twenty-four hour VCUG cannot replace follow-up VCUG usually performed beyond 3 months postoperatively. Further studies are needed for confirmation of cure.
authors.affiliation: Department of Urology, Korea University Medical Center, Seoul, Korea.
authors.forename: Mi Mi
authors.initials: MM
authors.lastname: Oh
authors.affiliation: Deparment of Urology, Inje University, Seoul, Korea.
authors.forename: Min Gu
authors.initials: MG
authors.lastname: Park
authors.affiliation: Department of Urology, Korea University Medical Center and Korea University Institute of Regenerative Medicine, Seoul, Korea.
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Korea University Medical Center, Seoul, Korea.
authors.forename: Kee Hwan
authors.initials: KH
authors.lastname: Yoo
authors.affiliation: Department of Pediatrics, Hallym University, Kangnam Sacred Heart Hospital, Seoul, Korea.
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Urology, Korea University Medical Center and Korea University Institute of Regenerative Medicine, Seoul, Korea.
authors.forename: Cheol Yong
authors.initials: CY
authors.lastname: Yoon
authors.affiliation: Department of Urology, Korea University Medical Center, Seoul, Korea.
authors.forename: Hong Seok
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Urology, Korea University Medical Center and Korea University Institute of Regenerative Medicine, Seoul, Korea. Electronic address: dgmoon@korea.ac.kr.
authors.forename: Du Geon
authors.initials: du G
authors.lastname: Moon
mesh_terms: D002648:Child; D003911:Dextrans / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007267:Injections; D008297:Male; D011237:Predictive Value of Tests; D011859:Radiography; D015203:Reproducibility of Results; D013997:Time Factors; D014521:Urethra / Q000000981:diagnostic imaging*; D001743:Urinary Bladder / Q000000981:diagnostic imaging*; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
chemical_list: D003911:Dextrans; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid