Mechanism of vesicoureteral reflux: High detrusor pressure versus low ureteral resistance A narrative review

IF 2.1 4区医学 Q2 PEDIATRICS

Pediatrics and Neonatology Pub Date : 2025-04-02 DOI:10.1016/j.pedneo.2025.01.013

Tze-Chen Chao , Li Yi Lim , Stephen S. Yang

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引用次数: 0

Abstract

The objective of this narrative review is to deepen the understanding of vesicoureteral reflux (VUR) by exploring its historical context, current treatments and their outcomes, as well as offering an alternative perspective on this condition.

VUR was first identified in patients with neurogenic bladder following spinal cord injury; it has since been linked to urinary tract infections in newborns and children. The classical theory of primary VUR is that it is caused by the short submucosal ureteral tunnel which leads to low ureteral resistance, thus leading to the development of various surgical methods to increase the ureteral resistance. However, growing evidence indicates that secondary VUR, caused by elevated detrusor pressure, may be a more common cause. Hence, it is critical to identify low urinary tract obstruction during the voiding cystourethrogram or raised detrusor pressure as the cause of the VUR before attempting surgical correction. More studies are necessary to support this position and enhance the treatment outcomes for VUR patients.

查看原文本刊更多论文

膀胱输尿管反流的机制：高逼尿肌压力与低输尿管阻力。

这篇叙述性综述的目的是通过探讨膀胱输尿管反流（VUR）的历史背景、目前的治疗方法和结果，以及提供对这种疾病的另一种观点，加深对VUR的理解。VUR首先在脊髓损伤后的神经源性膀胱患者中发现；此后，它与新生儿和儿童的尿路感染有关。原发性VUR的经典理论是由于粘膜下输尿管隧道较短，导致输尿管阻力低，从而导致各种手术方法的发展，以增加输尿管阻力。然而，越来越多的证据表明，由逼尿肌压力升高引起的继发性VUR可能是更常见的原因。因此，在尝试手术矫正之前，在排尿膀胱输尿管造影中确定下尿路梗阻或逼尿肌压力升高是引起VUR的关键。需要更多的研究来支持这一观点，并提高VUR患者的治疗效果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatrics and Neonatology PEDIATRICS-

CiteScore

3.10

自引率

0.00%

发文量

170

审稿时长

48 days

期刊介绍： Pediatrics and Neonatology is the official peer-reviewed publication of the Taiwan Pediatric Association and The Society of Neonatology ROC, and is indexed in EMBASE and SCOPUS. Articles on clinical and laboratory research in pediatrics and related fields are eligible for consideration.