Treatment Outcomes of Subureteric Injection and Ureteroneocystostomy in Children with Vesicoureteral Reflux

Objective: This study was designed to evaluate patients treated with subureteric injection (STING) and ureteroneocystostomy by the Lich-Gregoir technique (LGT) due to vesicoureteral reflux (VUR) in terms of radiologic, scintigraphic images, laboratory findings and bladder functions and determine the effectiveness of both treatment modalities. Methods: A total of 106 patients, who were treated with STING and ureteroneocystostomy between January 2002-2010 were investigated. Patients’ age, gender, complaints at presentation, bladder function impairment, laboratory outcome and radiologic and scintigraphic findings were retrospectively examined. The relationship among VUR grades and pelvicalyceal ectasia, scars, treatment modalities and outcome were evaluated. Results: Left VUR was found in 68(64%) and right VUR in 38(36%) of the patients. The most common level of VUR was Grade III (42 patients, 40%). Additional urologic pathologies were found in 60 of the 106 of patients (57%). Pelvicalyceal ectasia was found in 44 (42%) and scars were seen in dimercaptosuccinic acid (DMSA) in 54 (51%) of the patients. In total 86 (81%) of 106 patients with VUR recovered completely and 20 (19%) patients with VUR regressed. Conclusion: STING is a good alternative especially for patients with low grade VUR. However, it has some drawbacks, such as requiring a long follow-up period, having a lower rate of success compared to open surgery and being less effective in patients with high grade VUR. Ureteroneocystostomy (LGT) is a method with less morbidity and a high success rate, especially in the treatment of patients with higher grade VUR. J Clin Exp Invest 2016; 7 (2): 168-173

Keywords:

Children, vesicoureteral reflux, reflux nephropathy subureteric injection,

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