Intraoperative contrast-enhanced urosonography during endoscopic treatment of vesicoureteral reflux in children.
BACKGROUND
There are many controversies surrounding the effectiveness of endoscopic treatment of vesicouretheral reflux (VUR) in children, thus it is of highest priority to analyze factors influencing the outcome of therapy and to search for new methods that would increase the success rate and reduce the number of reinjections.


OBJECTIVE
The aim of the study was to analyze whether intraoperative contrast-enhanced urosonography (ce-US) may increase the effectiveness of endoscopic anti-reflux therapy.


METHODS
Intraoperative contrast-enhanced urosonography (ce-US) with SonoVue® was performed in 17 patients (25 ureteral units) undergoing endoscopic treatment of VUR. Ce-US was performed in the operating room before the procedure and after injection of the bulking material. When VUR persisted, the operator repeated the injection, which was followed by ce-US. The results were compared with those obtained from a control group (15 patients; 22 ureteral units).


RESULTS
A repeat injection during a single endoscopic treatment was required in 24% of cases. The overall success rate confirmed at 6-12 months' follow-ups was 84%. The success rate was significantly higher in comparison to the control group (success: 64%).


CONCLUSIONS
Intraoperative ce-US performed during endoscopic treatment of VUR enables immediate monitoring of outcome and provides the opportunity for repeat injection during the same procedure, thus increasing the efficacy of the procedure and reducing the number of reinjections.
Department of Pediatric Radiology, Medical University of Lublin, Al. Racławickie 1, 20-059, Lublin, Poland, mwozniak@hoga.pl.
Magdalena Maria
MM
Woźniak
Paweł
P
Osemlak
Agata
A
Pawelec
Agnieszka
A
Brodzisz
Paweł
P
Nachulewicz
Andrzej Paweł
AP
Wieczorek
Maria Małgorzata
MM
Zajączkowska
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D003911:Dextrans / Q000008:administration & dosage; D004724:Endoscopy; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage; D007223:Infant; D007430:Intraoperative Care; D008297:Male; D010743:Phospholipids; D011446:Prospective Studies; D013459:Sulfur Hexafluoride; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging* / Q000601:surgery*
D003287:Contrast Media; D003911:Dextrans; D010743:Phospholipids; C420843:contrast agent BR1; C094535:deflux; D006820:Hyaluronic Acid; D013459:Sulfur Hexafluoride