ESPU Congress 2018 - Abstract Book

60 29 th CONGRESS OF THE ESPU 09:22–09:25 S5-7 (PP) A META-ANALYSIS OF THE FATE OF CONTRALATERAL VESICO-URETERAL REFLUX IN UNILATERAL MULTICYSTIC DYSPLASTIC KIDNEY Tomer ERLICH  1 and Luis BRAGA  2 1) Sheba medical center Tel Hashomer, Urology, Ramat Gan, ISRAEL - 2) McMaster Children Hospital, McMaster University, Surgery, Hamilton, CANADA PURPOSE To describe the incidence, management (continuous antibiotic prophylaxis (CAP) use and surgical interventions) and evolution (UTI and spontaneous resolution rates) of each vesico-ureteral reflux (VUR) grade in the contralateral kidney of unilateral multicystic dysplastic kidney (MCDK) patients, in order to strengthen the scientific basis regarding the need for voiding cystourethrography (VCUG) screening. MATERIAL AND METHODS A comprehensive search of MEDLINE, EMBASE, CINHAL, WEB OF SCIENCE, COCHRANE and gray literature was performed (1950 – July 2015). Full-text screening, data abstraction and quality appraisal were conducted in duplicate. Included studies reported a primary diagnosis of unilateral MCDK with contralateral VUR determined by VCUG. Articles had to include a distribution of VUR grade to meet the eligibility criteria. RESULTS From 657 retrieved articles, 37 studies enrolling 2057 patients were analyzed. 87 % (80–92 %) were diagnosed with MCDK prenatally (80 % males). 1800 patients had VCUG, 303 had VUR (weighted proportion 17 %; 95 % CI: 14 %–20). Weighted proportions of VUR were 9 %, 7 % and 17 % for grades I–II, III–V, and I–V, respectively. 99 % of patients were on CAP and 18 % (95 % CI: 8–37 %) had UTIs, with a higher rate of UTIs (23 % vs 10 %) in patients with dilating (grades 3–5) VUR, over a mean follow-up of 40 months. In patients with dilating VUR, reflux resolved or downgraded to grade I in 52 % of patients, and 11 % had surgical correction of VUR. CONCLUSIONS Dilating VUR proportion is significant (7 %) in the contralateral functioning kidney of patients with unilateral MCDK but due to lack of sufficient conclusive data, VCUG screening cannot be explicitly recommended.