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PubMed · 12511837

[Vesicoureteric reflux and functional voiding dysfunction in children].

Y Badachi·P Pietrera·A Liard·C Pfister·J N Dacher
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Abstract

PURPOSE: To analyze the efficacy of the different treatments of vesicoureteric reflux (VUR) associated with reflex bladder sphincter dyssynergia (RBSD). PATIENTS AND METHODS: The medical records of 33 children (28 girls) aged 4 to 12 years presenting reflex bladder sphincter dyssynergia and vesicoureteric reflux have been reviewed. The most common clinical symptom was urinary tract infection. Voiding dysfunction included: dysuria, urinary leak, enuresia, urgency, constipation. In most cases, vesicoureteric reflux was low grade (grade 1, n=9; grade 2, n=18; grade 3, n=6) and bilateral (n=18). Three types of treatments have been utilized: reimplantation, reeducation, medical treatment (diet, antibio-prophylaxis, anti-cholinergics). RESULTS: Eleven children (2 with a solitary kidney) underwent early reimplantation which was effective on vesicoureteric reflux but 6 of them had post-operative voiding dysfunction and 5 had a new episode of urinary infection. Six had reeducation first then they underwent reimplantation. Sixteen children had an exclusive medical treatment (13 with reeducation). In 9 children vesicoureteric reflux disappeared (one child still complains of voiding dysfunction). In 7, voiding dysfunction improved but vesicoureteric reflux is still present. CONCLUSION: The management of vesicoureteric reflux associated with reflex bladder sphincter dyssynergia is complex. Surgery should certainly not be the initial treatment. However, it can remain useful if one wishes to get complete resolution of reflux.

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Anti-Bacterial AgentsBiofeedback, PsychologyChildChild, PreschoolCholinergic AntagonistsCombined Modality TherapyDietFemaleHumansMalePatient Education as TopicPatient SelectionReplantationRetrospective StudiesSeverity of Illness IndexToilet TrainingTreatment OutcomeUreterUrinary Tract InfectionsUrination DisordersUrodynamicsUrographyVesico-Ureteral RefluxEnglish AbstractJournal Article

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Y Badachi, P Pietrera, A Liard, C Pfister, J N Dacher. 2002. [Vesicoureteric reflux and functional voiding dysfunction in children].. https://pubmed.ncbi.nlm.nih.gov/12511837/

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