Endoscopic and Conservative Treatment of Vesicoureteric Reflux
1,2Dítě Z., 1,2Kočvara R., 1,2Dvořáček J., 3Langer J., 1Sedláček J.
1Urologická klinika 1. LF UK a VFN, Praha 2Subkatedra dětské urologie a Katedra urologie IPVZ, Praha 3Klinika dětského a dorostového lékařství, Praha
Background. The aim of study is to evaluate the results of endoscopic treatment of vesicoureteric reflux
(VUR) comparing with conservative mode.
Methods and Results. In the years 2003–2006 there were forty for children in prospective randomised
study enrolled and divided into two groups. Twenty two children 1–40 months old ( 22,9 months) were
operated. Dx/Ha (Deflux®) was instilled for VUR grade 3–5. The results of treatment were compared
with outcome of twenty two conservatively treated randomly assigned children aged 1–32 months (mean
age 13.5 months) Postoperative videourodynamic study was used to evaluate for the presence of VUR
and function of the bladder and ultrasound investigation was performed too (exclusion of obstructive
megaureter in operated group). There were 22 children controled after instillation. The children were
followed 11–24 months. VUR was cured in 12 cases (54.5 %) and improved (grade 1–2) in 5 children
(66,7 %). All children absolved treatment without any complications, excluding one case with
obstructive megaureter after pyelonephritis diagnosed. There were 22 children evaluated in conservative
group. Five children were cured (22.7 %) and VUR was improved (grade 1–2) in four (18.2 %)
Conclusions. Endoscopic miniinvasive instillation of dextranomer is safe and effective treatment of
VUR in all age groups with good therapeutical outcome and minimum of adverse effects.
Vesicoureteral reflux, endoscopic transurethral instillation, antibacterial chemoprofylaxis,