Objective
To characterize patients who develop late obstruction after subureteral injection
of bulking agent for the treatment of pediatric vesicoureteral reflux (VUR).
Methods
We retrospectively evaluated the medical records of all patients who underwent endoscopic
injection for the correction of VUR during 2008-2015 in 2 centers in Israel: Bnai-Zion
Medical Center, Haifa, and Schneider Children's Medical Center, Petah Tikva. Nine
patients who developed late-onset obstruction were included in the study, and their
data were reviewed and analyzed.
Results
Three boys and 6 girls with mean age of 3 years were included in the study. All patients
had moderate-to-high grade VUR. Following injection, all children had a radiographic
evidence showing resolution of the reflux. During follow-up, patients were diagnosed
with late obstruction in a mean time of 13.4 months. All patients underwent open re-implantation.
Conclusion
Late-onset obstruction may develop in patients treated with subureteral injection
for VUR. Patients with high grade reflux and dilated ureters are at risk of late obstruction.
Long-term follow-up with ultrasound is mandatory following endoscopic treatment of
VUR.
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Article info
Publication history
Published online: December 16, 2016
Accepted:
December 12,
2016
Received:
October 7,
2016
Footnotes
Financial Disclosure: The authors declare that they have no relevant financial interests.
David Ben-Meir and Zaher Bahouth contributed equally to this work.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
