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28
TH
CONGRESS OF THE ESPU
09:14–09:17
S5-4 (PP)
WHAT ARE THE PREDICTIVE FACTORS LEADING
TO THE URETERIC OBSTRUCTION FOLLOWING
ENDOSCOPIC CORRECTION OF VUR?
Boris CHERTIN
1
, Stanislav KOCHEROV
2
, Sonia ZILBER
3
, Ermelinda MELE
4
,
Simona GEROCARNI NAPPO
5
and Nicola CAPOZZA
5
1) Shaare Zedek Medical Centre, Paediatric Urology, Jerusalem, ISRAEL - 2) Shaare Zedek Medical Center, Jerusalem,
ISRAEL - 3) Shaare Zedek Medical Center, Pathology, Jerusalem, ISRAEL - 4) Bambino Gesù Children’s Hospital,
Pediatric Urology unit, Rome, ITALY - 5) Bambino Gesù Children’s Hospital, Rome, ITALY
PURPOSE
We have retrospectively evaluated all cases of obstruction following endoscopic treatment of VUR
with two different tissue augmenting substances. A statistical analysis of the predictive factors that
might lead to the increased incidence of obstruction was performed.
MATERIAL AND METHODS
2495 patients underwent endoscopic correction of VUR utilizing Deflux (1790) and Vantris (705).
9(0.5%) children (3 F and 6 M) in Deflux group and 9(1.3%) (5 F and 4 M) in Vantris group developed
UVJ obstruction. Obstruction developed during the period ranging from 2 to 49 months (average
16 months) following endoscopic correction. The primary reflux grade was III in 7, IV in 6 and V in
6 children respectively. The mean volume of the injected material in all obstructed patients was 0.9 +
0.6 cc (mean+ SD).
RESULTS
The statistical analysis of nonhomogeneous population demonstrated higher obstruction rate in
patients from the Vantris group. However, no statistical difference was demonstrated regarding the
obstruction rate in the homogenous group with relation to gender, age and reflux grade group of
patients. Moreover, univariate analysis revealed that type of injected material, gender and number
of injections are not significant predictive factors for obstruction. However, Grade V Reflux, the pres-
ence of beak sign on the reviewed pretreatment VCUG (12(66.7%) out of 18 obstructive ureters)
and inflamed bladder mucosa upon injection were significant independent risk factors leading to
obstruction.
CONCLUSIONS
High reflux grade, presence of obstructive/refluxing megaureter and inflamed bladder mucosa
are only statistically significant and independent predictive factors for UVJ obstruction following
endoscopic correction of VUR.