Top

Published in:

Open Access 01-09-2014 | Original Article

Intraoperative contrast-enhanced urosonography during endoscopic treatment of vesicoureteral reflux in children

Authors: Magdalena Maria Woźniak, Paweł Osemlak, Agata Pawelec, Agnieszka Brodzisz, Paweł Nachulewicz, Andrzej Paweł Wieczorek, Maria Małgorzata Zajączkowska

Published in: Pediatric Radiology | Issue 9/2014

Abstract

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.

Materials and 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%).

Conclusion

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.

Available only for authorised users

Kim JW, Oh MM (2013) Endoscopic treatment of vesicoureteral reflux in pediatric patients. Korean J Pediatr 56:145–150PubMedCentralPubMedCrossRef

Puri P, Kutasy B, Colhoun E et al (2012) Single center experience with endoscopic subureteral dextranomer/hyaluronic acid injection as first line treatment in 1,551 children with intermediate and high grade vesicoureteral reflux. J Urol 188:1485–1489PubMedCrossRef

Elder JS, Diaz M, Caldamone AA et al (2006) Endoscopic therapy for vesicoureteral reflux: a meta-analysis. I. Reflux resolution and urinary tract infection. J Urol 175:716–722PubMedCrossRef

Haferkamp A, Contractor H, Mohring K et al (2000) Failure of subureteral bovine collagen injection for the endoscopic treatment of primary vesicoureteral reflux in long-term follow-up. Urology 55:759–763PubMedCrossRef

Guerra LA, Khanna P, Levasseur M et al (2007) Endoscopic treatment of vesicoureteric reflux with Deflux: a Canadian experience. Can Urol Assoc J1:41–45

Riccabona M, Avni FE, Damasio MB et al (2012) ESPR Uroradiology Task Force and ESUR Paediatric Working Group–Imaging recommendations in paediatric uroradiology, part V: childhood cystic kidney disease, childhood renal transplantation and contrast-enhanced ultrasonography in children. Pediatr Radiol 42:1275–1283PubMedCrossRef

Darge K, Troeger J (2002) Vesicoureteral reflux grading in contrast-enhanced voiding urosonography. Eur J Radiol 43:122–128PubMedCrossRef

Darge K, Papadopoulou F, Ntoulia A et al (2013) Safety of contrast-enhanced ultrasound in children for non-cardiac applications: a review by the Society for Pediatric Radiology (SPR) and the International Contrast Ultrasound Society (ICUS). Pediatr Radiol 43:1063–1073PubMedCrossRef

Garcia-Aparicio L, Rovira J, Blazquez-Gomez E et al (2013) Randomized clinical trial comparing endoscopic treatment with dextranomer hyaluronic acid copolymer and Cohen’s ureteral reimplantation for vesicoureteral reflux: Long−term results. J Pediatr Urol 9:483–487PubMedCrossRef

10.

Neel KF (2012) Endoscopic correction of vesicoureteric reflux: 10-year experience of a tertiary care center. Saudi J Kidney Dis Transpl 23:48–52PubMed

11.

Kajbafzadeh AM, Tourchi A, Aryan Z (2013) Factors that impact the outcome of endoscopic correction of vesicoureteral reflux: a multivariate analysis. Int Urol Nephrol 45:1–9PubMedCrossRef

12.

Alkan M, Ciftci AO, Senocak ME et al (2008) Endoscopic treatment of vesicoureteral reflux in children: our experience and analysis of factors affecting success rate. Urol Int 81:41–46PubMedCrossRef

13.

Elder JS, Shah MB, Batiste LR et al (2007) Part 3: Endoscopic injection versus antibiotic prophylaxis in the reduction of urinary tract infections in patients with vesicoureteral reflux. Curr Med Res Opin 23:S15–20PubMedCrossRef

14.

Pichler R, Buttazzoni A, Bektic J et al (2011) Endoscopic treatment of vesicoureteral reflux using dextranomer/hyaluronic acid copolymer in children: results of postoperative follow-up with real-time 3D sonography. Urol Int 87:192–198PubMedCrossRef

15.

Parente A, Tardaguila AR, Romero R et al (2013) Is intraoperative surgeon’s opinion an accurate tool to assess the outcome of endoscopic treatment for vesicoureteral reflux? J Pediatr Urol 9:1145–1149PubMedCrossRef

16.

Papadopoulou F, Ntoulia A, Siomou E et al. (2014) Contrast-enhanced voiding urosonography with intravesical administration of a second-generation ultrasound contrast agent for diagnosis of vesicoureteral reflux: prospective evaluation of contrast safety in 1,010 children. Pediatr Radiol [Epub ahead of print]

17.

Riccabona M (2012) Application of a second-generation US contrast agent in infants and children–a European questionnaire-based survey. Pediatr Radiol 42:1471–1480PubMedCrossRef

18.

Piscaglia F, Nolsoe C, Dietrich CF et al (2012) The EFSUMB guidelines and recommendations on the clinical practice of contrast enhanced ultrasound (CEUS): update 2011 on non-hepatic applications. Ultraschall Med 33:33–59PubMedCrossRef

19.

Liao YH, Lin CL, Wei CC et al. (2013) Subsequent cancer risk of children receiving post voiding cystourethrography: A nationwide population-based retrospective cohort study. Pediatric Nephrology [Epub ahead of print]

20.

Woźniak MM, Pawelec A, Wieczorek AP, Zajączkowska MM, Borzęcka H, Nachulewicz P (2013) 2D/3D/4D contrast-enhanced voiding urosonography in the diagnosis and monitoring of treatment of vesicoureteral reflux in children – can it replace voiding cystourethrography? Journal of Ultrasonography 13: 394–407

21.

Duran C, Valera A, Alguersuari A et al (2009) Voiding urosonography: the study of the urethra is no longer a limitation of the technique. Pediatr Radiol 39:124–131PubMedCrossRef

Title: Intraoperative contrast-enhanced urosonography during endoscopic treatment of vesicoureteral reflux in children
Authors: Magdalena Maria Woźniak
Paweł Osemlak
Agata Pawelec
Agnieszka Brodzisz
Paweł Nachulewicz
Andrzej Paweł Wieczorek
Maria Małgorzata Zajączkowska
Publication date: 01-09-2014
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Radiology / Issue 9/2014
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI: https://doi.org/10.1007/s00247-014-2963-7

At a glance: The STEP trials

Springer Medicine

Intraoperative contrast-enhanced urosonography during endoscopic treatment of vesicoureteral reflux in children

Abstract

Background

Objective

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Objective

Materials and methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 9/2014

Erratum to: High-resolution CT with histopathological correlates of the classic metaphyseal lesion of infant abuse

ACR Committee on Pediatric Imaging Research

Ischial apophyseal fracture in an abused infant

Strain measurement by cardiovascular magnetic resonance in pediatric cancer survivors: validation of feature tracking against harmonic phase imaging

Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

Bilateral agenesis of the anterior cruciate ligament: MRI evaluation