Usefulness of the classification of urinary dysfunction for the prognosis of the first endoscopic treatment of vesicoureteral reflux in children over the age of 3

Autores de IIS La Fe

• Leopoldo Marzullo Zucchet

  Autor

• José Antonio March Villalba

  Autor

• Carlos Dominguez Hinarejos

  Autor

• Alba Polo Rodrigo

  Autor

• Agustin Serrano Durba

  Autor

• Francisco Boronat Tormo

  Autor

Grupos

• Urología

  Leader

  Francisco Boronat Tormo

Abstract

Objectives: To assess the diagnostic performance of urinary dysfunction patterns associated with vesicoureteral reflux (VUR) in children over the age of 3 according to the result of the first endoscopic treatment (ENDT1), grouped into a classification designed by our group (CMD.URILa Fe). Comparison with other current classifications such as that of Van Batavia et al. Material and methods: Ambispective cross-cutting study of a sample of 50 children. Exclusion criteria: previous ENDT, age < 3 years, anatomical or neurological anomalies and a history of ureteral or abdominopelvic surgery. Prior to the ENDT1, a bladder voiding function assessment by uroflowmetry + electromyography (UF-EMG) and post-mictional residue (ultrasound). Other variables from the bladder diary, pre-mictional bladder wall thickness and other clinical variables. The correction of VUR was assessed by isotope cystography 3 months after the treatment. Urinary patterns were classified according to the significant variables (URI-La Fe), and the diagnostic performance of this classification was assessed, comparing it to the classification of patients as proposed by Van Batavia et al. Results: Mean age: 6.8 +/- 2.28 years. Males/females (44%/56%). Grades of VUR (mild/moderate/severe). ENDT1 VUR correction rate: 77% (n = 38). Diagnostic performance (Van Batavia; URI-La Fe): correct prediction (37.5%; 75%), sensitivity (32.4%; 87.8%), specificity (54.5%; 46.6%), positive predictive value (70.6; 78.3%) and negative predictive value (19.4%; 63.6%). Conclusions: Our results show the usefulness of the non-invasive test and the classification of urinary dysfunction in children aged over 3 years prior to the first endoscopic treatment of VUR. (C) 2018 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.

Keywords

• Vesiocoureteral reflux; Urodynamics; Child; Urinary dysfunction