title: Endoscopic treatment of vesicoureteral reflux with non-simultaneous involuntary detrusor contraction in chronic spinal cord injury patients with neurogenic detrusor overactivity.
abstract: OBJECTIVE
  To analyze whether it is correct to use endoscopic treatment via bulking agents of vesicoureteral reflux (VUR) seen on video urodynamics with non-simultaneous involuntary detrusor contraction in chronic spinal cord injury (SCI) patients with neurogenic detrusor overactivity (NDO).
  
  
  METHODS
  A retrospective study was performed with a cohort of 76 patients (age 48.9 ± 14.4 years) (mean ± standard deviation) of both sexes with chronic SCI who underwent endoscopic treatment of VUR during the years 2008 to 2011. Patients were subjected to clinical examinations and video urodynamic studies preoperatively and 22 ± 11.4 months after the intervention.
  
  
  RESULTS
  Resolution of VUR was achieved in 46 cases (61%). Cured patients had a statistically significant younger age and showed stress urinary incontinence more frequently. On the contrary, a greater grade of VUR, presence of bilateral reflux and presence of NDO were positively associated with treatment failure. The variables that independently influenced the cure of the reflux were NDO and reflux grade.
  
  
  CONCLUSIONS
  The failure rate was high in patients with NDO, even though the reflux was not synchronous with involuntary detrusor contraction, and therefore these patients should have NDO eradicated before doing any anti-reflux procedures.
authors.affiliation: Department of Urology, Hospital Nacional de Parapléjicos, Toledo, Spain.
authors.forename: Miguel C
authors.initials: MC
authors.lastname: Vírseda
authors.forename: Jesús C
authors.initials: JC
authors.lastname: Salinas
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bolufer
authors.forename: Manuel F
authors.initials: MF
authors.lastname: Esteban
mesh_terms: D000328:Adult; D003911:Dextrans / Q000008:administration & dosage; D004129:Dimethylpolysiloxanes / Q000008:administration & dosage; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D007267:Injections; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D009130:Muscle, Smooth / Q000294:innervation*; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017211:Treatment Failure; D001743:Urinary Bladder / Q000294:innervation*; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014563:Urodynamics; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*
chemical_list: D003911:Dextrans; D004129:Dimethylpolysiloxanes; C094535:deflux; C013830:baysilon; D006820:Hyaluronic Acid