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Treatment of Bladder Dysfunction and High Grade Vesicoureteral Reflux Does Not Influence the Spontaneous Resolution Rate
- Source :
- Journal of Urology. 177:325-330
- Publication Year :
- 2007
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2007.
-
Abstract
- We investigated whether the treatment of bladder dysfunction in infants with congenital high grade vesicoureteral reflux could influence the spontaneous resolution rate of the reflux and the number of recurrent urinary tract infections.A total of 115 infants with high grade vesicoureteral reflux were included in a followup study of bladder function and reflux resolution between 1993 and 1999. The present study deals with 20 of these infants with mainly grade V reflux, most of whom had recurrent urinary tract infections in combination with high post-void residual and high bladder capacity. Treatment with clean intermittent catheterization was instituted during infancy in these 20 patients and continued until a median age of 4 years.Bladder capacity was high at presentation and at all followup investigations in the clean intermittent catheterization treated group. Moreover, residual urine was high at presentation and especially between ages 1 and 2 years. However, after bladder control was achieved this residual decreased and consisted mainly of reflux urine. In only 1 girl did reflux resolve spontaneously during the 4-year followup period. A total of 18 patients were treated surgically at the end of this period, and clean intermittent catheterization could be stopped a few months later in all but 2. Urinary tract infection recurrences were uncommon after the institution of treatment.The treatment of bladder dysfunction characterized by a high capacity bladder with poor emptying in infants with congenital high grade reflux does not influence the rate of spontaneous resolution. On the other hand, the tendency toward recurrent urinary tract infections appears to decrease with treatment.
- Subjects :
- Male
medicine.medical_specialty
Urology
Urinary system
medicine.medical_treatment
Remission, Spontaneous
Spontaneous remission
Vesicoureteral reflux
Urinary catheterization
medicine
Humans
Child
Vesico-Ureteral Reflux
Urinary bladder
business.industry
Infant, Newborn
Urinary Bladder Diseases
Reflux
Infant
Clean Intermittent Catheterization
medicine.disease
Surgery
medicine.anatomical_structure
Child, Preschool
Female
Urinary Catheterization
Urinary bladder disease
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15273792 and 00225347
- Volume :
- 177
- Database :
- OpenAIRE
- Journal :
- Journal of Urology
- Accession number :
- edsair.doi.dedup.....2d348d3cf542312640c2cd76bf7e035f