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Pediatric Surgery International

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Open Access 01-12-2024 | Vesicorenal Reflux | Original Article

Voiding cystourethrography in patients undergoing endoscopic decompression of duplex system ureteroceles: to do or not to do?

Authors: Giorgia Contini, Ermelinda Mele, Andrea Celeste Barneschi, Ciro Esposito, Marco Castagnetti

Published in: Pediatric Surgery International | Issue 1/2024

Abstract

Objective

To assess the role of voiding cystourethrography (VCUG) in patients with duplex system ureterocele (DSU) undergoing endoscopic decompression (ED).

Materials and methods

This is a retrospective study of 75 consecutive patients with DSU undergoing ED [median (range) age, 6 (1–148) months]. Patients were divided into 3 groups, 33 with a VCUG showing vesicoureteral reflux (VUR) before ED (VUR-group), 22 with a VCUG negative for VUR (No-VUR-group), and 20 who did not undergo a VCUG (No-VCUG-group). Secondary surgery (SS) rate was compared among groups.

Results

Groups were comparable for baseline characteristics. SS rate was 82% (27/33) in VUR-group vs. 32% (7/22) in the No-VUR-group (p = 0.0001), and 25% (5/20) in the No-VCUG-group (p = 0.001 vs. VUR-group, and 1 vs. No-VUR-group). In the VUR-group, 9 patients underwent preemptive endoscopic treatment of VUR during ED and SS rate was 44% (4/9) vs. 96% (23/24) in the remainder, p= 0.003. In the No-VCUG-group, a VCUG was performed during follow-up in 9/15 patients and showed reflux in all, although only 2 of these developed a (single) urinary tract infections.

Conclusions

SS rate was significantly higher in patients with preoperative VUR. Instead, it was not significantly different between patients without VUR and those who did not undergo a VCUG before ED, despite all the latter who underwent a VCUG during follow-up had evidence of VUR generally in the absence of symptoms. In our opinion, a VCUG could be limited to patients developing symptoms after ED. If a VCUG is performed before ED, a preemptive treatment of VUR should be taken into consideration.

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Title: Voiding cystourethrography in patients undergoing endoscopic decompression of duplex system ureteroceles: to do or not to do?
Authors: Giorgia Contini
Ermelinda Mele
Andrea Celeste Barneschi
Ciro Esposito
Marco Castagnetti
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Vesicorenal Reflux
Urinary Tract Infection
Published in: Pediatric Surgery International / Issue 1/2024
Print ISSN: 0179-0358
Electronic ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-024-05665-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Voiding cystourethrography in patients undergoing endoscopic decompression of duplex system ureteroceles: to do or not to do?

Abstract

Objective

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Materials and methods

Results

Conclusions

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