Efficacy of Three Different Injection Techniques for the Endoscopic Treatment of Vesicoureteral Reflux (VUR) in Children: A Review of 10 Years of Experience.

IF 2 Q2 UROLOGY & NEPHROLOGY

Research and Reports in Urology Pub Date : 2024-07-03 eCollection Date: 2024-01-01 DOI:10.2147/RRU.S467018

Giulia Lanfranchi, Irene Paraboschi, Ugo Maria Pierucci, Guglielmo Mantica, Sara Costanzo, Federica Marinoni, Andrea Pansini, Giorgio Giuseppe Orlando Selvaggio, Gloria Pelizzo

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引用次数: 0

Abstract

Aim: To review our 10 years of experience with the endoscopic treatment of vesicoureteral reflux (VUR) in children, emphasizing the long-term efficacy of the "combined STING-HIT" technique.

Materials and methods: A retrospective study was performed including all children with symptomatic VUR undergoing the cystoscopic injection of bulking agents from January 2013 to December 2022 in our pediatric tertiary referral center. Three different endoscopic techniques were adopted: the "combined STING-HIT" technique, the STING technique, and the HIT technique. Treatment success was defined as symptom remission and VUR resolution on the voiding cystourethrogram (VCUG) performed at the 3-month follow-up.

Results: In the study period, 140 (F:M = 64:76) patients and 228 ureters were treated at a median patient age of 3 (2.0-6.0) years. After a single endoscopic treatment, VUR resolved in 203 (88%) ureters. The VUR resolution rate after a single endoscopic treatment was 95% (n=70/74) in case of I-II VUR, 88% (n=87/99) in case of III VUR; 83% (n=38/46) in case of IV VUR; 89% (n=8/9) in case of V VUR (p-value: 0.174). Overall, one or two endoscopic treatments succeeded in 219 (96%) ureters. The overall VUR resolution rate following one or two endoscopic treatments was 100% (74/74) in case of I-II VUR, 93% (n=92/99) in case of III VUR; 96% (n=44/46) in case of IV VUR; 100% (n=9/9) in case of V VUR (p-value: 0.083). Despite not being statistically significant, the VUR resolution rate was higher for the "combined STING-HIT" technique, both after one (92%: n=110/119; versus 85%; n=62/73 versus 86%; n=31/36; p-value: 0.225) or two (98%: n=116/119; versus 95%; n=69/73 versus 94%; n=34/36; p-value: 0.469) endoscopic treatments.

Conclusion: The endoscopic approaches were highly successful for the treatment of VUR in children. The "combined STING-HIT" technique was a safe and effective procedure, being associated with the higher resolution rate.

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儿童膀胱输尿管反流（VUR）内窥镜治疗中三种不同注射技术的疗效：十年经验回顾

目的：回顾我们10年来在内镜下治疗儿童膀胱输尿管反流（VUR）的经验，强调 "联合STING-HIT "技术的长期疗效：2013年1月至2022年12月期间，我们在儿科三级转诊中心对所有接受膀胱镜注射膨胀剂治疗的无症状VUR患儿进行了回顾性研究。采用了三种不同的内镜技术："STING-HIT联合 "技术、STING技术和HIT技术。治疗成功的定义是症状缓解和3个月随访时的排尿膀胱尿道造影（VCUG）显示VUR消失：在研究期间，共治疗了 140 名（女：男=64：76）患者和 228 个输尿管，患者的中位年龄为 3（2.0-6.0）岁。经过一次内窥镜治疗后，203 个（88%）输尿管的 VUR 得到缓解。经过一次内窥镜治疗后，I-II期VUR的VUR缓解率为95%（n=70/74）；III期VUR的VUR缓解率为88%（n=87/99）；IV期VUR的VUR缓解率为83%（n=38/46）；V期VUR的VUR缓解率为89%（n=8/9）（P值：0.174）。总体而言，219 个（96%）输尿管成功接受了一次或两次内窥镜治疗。经过一次或两次内窥镜治疗后，Ⅰ-Ⅱ期VUR的总治愈率为100%（74/74）；Ⅲ期VUR为93%（n=92/99）；Ⅳ期VUR为96%（n=44/46）；Ⅴ期VUR为100%（n=9/9）（P值：0.083）。尽管没有统计学意义，但 "STING-HIT联合 "技术的VUR解决率更高，无论是经过一次（92%：n=110/119；对85%；n=62/73对86%；n=31/36；p值：0.225）还是两次（98%：n=116/119；对95%；n=69/73对94%；n=34/36；p值：0.469）内窥镜治疗：结论：内窥镜方法治疗儿童尿崩症非常成功。结论：内窥镜方法在治疗儿童尿道瘘方面非常成功，"STING-HIT联合 "技术是一种安全有效的治疗方法，具有较高的治愈率。

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来源期刊

Research and Reports in Urology UROLOGY & NEPHROLOGY-

CiteScore

3.40

自引率

0.00%

发文量

审稿时长

16 weeks

期刊介绍： Research and Reports in Urology is an international, peer-reviewed, open access, online journal. Publishing original research, reports, editorials, reviews and commentaries on all aspects of adult and pediatric urology in the clinic and laboratory including the following topics: Pathology, pathophysiology of urological disease Investigation and treatment of urological disease Pharmacology of drugs used for the treatment of urological disease Although the main focus of the journal is to publish research and clinical results in humans; preclinical, animal and in vitro studies will be published where they will shed light on disease processes and potential new therapies. Issues of patient safety and quality of care will also be considered.