Early endoscopic injection may prevent new scarring in idiopathic detrusor overactivity disorder with vesicoureteral reflux in children

Pediatr Surg Int. 2022 Jul;38(7):1075-1082. doi: 10.1007/s00383-022-05129-8. Epub 2022 May 4.

Abstract

Objective: To present baseline characteristics and the long-term treatment results of three groups of patients with idiopathic detrusor overactivity (IDOD) and vesicoureteral reflux (VUR) according to different treatment regimens, which underwent endoscopic subureteric injection (STING) in the early phase of targeted treatment (TT) (ES group), underwent STING in the late phase of TT (LS group) and with TT only (TT group).

Patients and methods: A total of 49 IDOD cases with VUR which were divided into three groups according to treatment regimens were evaluated in terms of age, symptoms, bladder capacities, involuntary contraction pressures (ICP), presence and degree of renal scar, differential renal functions (DF), new scar formation and STING success.

Results: There was no significant difference between the groups in terms of age, side, symptoms, presence of urinary tract infection (UTI), DF, ICP and bladder capacity at diagnosis. A high grade of reflux was found to be significantly lower in the TT group (p = 0.037). There was no significant difference in terms of ICP, DF, bladder capacity and reflux grade between ES and LS Group. But new scar formation was more in LS Group (p = 0.003).

Conclusion: The STING success is satisfactory in IDOD cases with VUR, waiting a long period of time for diminishing symptoms may cost new scar formation.

Keywords: Endoscopic subureteric injection; Idiopathic detrusor overactivity; Lower urinary tract dysfunction; STING; Vesicoureteral reflux.

MeSH terms

  • Child
  • Cicatrix / etiology
  • Cicatrix / prevention & control
  • Humans
  • Infant
  • Retrospective Studies
  • Urinary Bladder, Overactive* / drug therapy
  • Urinary Bladder, Overactive* / etiology
  • Urodynamics
  • Vesico-Ureteral Reflux* / complications