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Artículo Tomo 71, Número. 5, Junio 2018

Archivos Españoles de Urología

Endoscopically treated vesicoureteral reflux: Evolution of the recurrences.

Authors: Sara Fuentes, Andrés Gómez-Fraile, Isabel Carrillo-Arroyo, Daniel Cabezalí-Barbancho y Cristina Tordable-Ojeda.

Arch. Esp. Urol. 2018; 71 (5): 495-501

Vol. 71, Number. 5, June 2018

OBJECTIVES: In recent years, different studies have mentioned the recurrence of vesicoureteral reflux (VUR) endoscopically resolved, an exceptional event after open surgery. The aim of this study is to describe the evolution of the cases of recurrence identified in our center to assess the importance of this event. METHOD: We have identified the cases of VUR that recurred after successful endoscopic treatment in our anesdepartment. We have analyzed diagnostic tests, management and final outcome. RESULTS: In our series, we have a 19.5% incidence of VUR recurrence after endoscopic correction. Out of these patients, 66.2% were asymptomatic. Ultrasound (US) showed modifications only in two of the cases. Five of them had worsen differential renal function in the Tc- 99 dimercapto succinyl choline acid scan (DMSA). We performed a new endoscopic procedure in 49 ureteral units with a success rate of 75.5%. CONCLUSIONS: Most patients with VUR recurrence were asymptomatic, with no alterations in US or DMSA scan. Both endoscopic treatment or surveillance might be appropriate in this setting. These data lead us to reckon that the systematic search for VUR relapse in the asymptomatic patient might not be necessary. Similarly, ultrasound or DMSA monitoring should be aimed to the assessment of established reflux nephropathy, regardless of the possibility of recurrence.

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