title: Routine delayed voiding cystourethography after initial successful endoscopic treatment with Dextranomer/Hialuronic Acid Copolimer (Dx/HA) of vesicoureteral reflux (VUR). Is it necessary?
abstract: BACKGROUND
  Some guidelines recommend an early voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR), but there's no consensus if it's necessary a long-term follow-up in these patients. The aim of our study is analyze if it's necessary a delayed VCUG after initial successful treatment with Dx/HA.
  
  
  METHODS
  We have reviewed all medical charts of patients that underwent Dx/HA treatment from 2006 to 2010. We have selected patients with initial successful treatment and more than 3 years of radiological and clinical follow-up. We have analyzed late clinical and radiological outcomes.
  
  
  RESULTS
  One hundred and sixty children with 228 refluxing ureters underwent Dx/HA endoscopic treatment with a mean follow-up of 52.13 months. Early VCUG was performed in 215 ureters with an initial successful rate of 84.1%. The group of study was 94/215 ureters with more than 3 years of follow-up with a delayed VCUG. VUR was still resolved in 79,8% of the ureters. Clinical success rate was 91.7%. The incidence of febrile urinary tract infection in those patients with cured VUR and those with a relapsed VUR was 8 and 15%, respectively; but there were no significant differences. We have not found any variable related with relapsed VUR except those ureters that initially received 2 injections (P<.05).
  
  
  CONCLUSIONS
  If our objective in the treatment of VUR is to reduce the incidence of febrile urinary tract infection it is not necessary to perform a delayed VCUG even though the long-term radiological outcomes is worse than clinical outcome.
authors.affiliation: Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España. Electronic address: lgarcia@hsjdbcn.org.
authors.forename: L
authors.initials: L
authors.lastname: García-Aparicio
authors.affiliation: Servicio de Anestesiología, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España.
authors.forename: E
authors.initials: E
authors.lastname: Blázquez-Gómez
authors.affiliation: Sección de Nefrología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España.
authors.forename: A
authors.initials: A
authors.lastname: Vila Santandreu
authors.affiliation: Sección de Nefrología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Camacho Diaz
authors.affiliation: Sección de Nefrología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España.
authors.forename: J
authors.initials: J
authors.lastname: Vila-Cots
authors.affiliation: Sección de Nefrología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España.
authors.forename: M
authors.initials: M
authors.lastname: Ramos Cebrian
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España.
authors.forename: I
authors.initials: I
authors.lastname: de Haro
authors.affiliation: Servicio de Cirugía Pediátrica, Sección de Urología Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España.
authors.forename: O
authors.initials: O
authors.lastname: Martin
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, España.
authors.forename: X
authors.initials: X
authors.lastname: Tarrado
mesh_terms: D002675:Child, Preschool; D000070621:Cystography; D003558:Cystoscopy; D003911:Dextrans / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D008297:Male; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors; D018666:Ureteroscopy; D014521:Urethra / Q000000981:diagnostic imaging*; D014554:Urination; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging* / Q000628:therapy*
chemical_list: D003911:Dextrans; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid
keywords: Children; Cistografía; Cystography; Endoscopia; Endoscopy; Infancia; Reflujo vesicoureteral; Vesicoureteral reflux