Endoscopic treatment of symptomatic VUR disease after the renal transplantation: analysis of 49 cases
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Background To evaluate the outcome of endoscopic treatment for symptomatic vesicoureteral refux (VUR) disease in renal transplantation patients and to determine the factors that were associated with the success rate of the treatment. Methods A total of 121 symptomatic VUR diseases diagnosed between 2014 and 2018 in 3560 renal transplant patients. The results of 49 VUR cases that presented with febrile urinary tract infection (UTI) and were hospitalized for antibiotic treatment were included in the study. Refux was detected by voiding cystourethrogram and treatment was performed by endoscopic Defux® injection. The result of endoscopic treatment was evaluated clinically by 3 months periods. Results The mean time between transplantation and endoscopic treatment was 59.6 (5–132) months, and the mean followup period after the endoscopic treatment was 14 (6–48) months, respectively. The success rate after the frst injection was 59.1% (n=29) and 67.3% (n=33) after the second injection. One patient developed anuria, one patient febrile UTI and four patients developed minimal macroscopic hematuria after the procedure. Conclusions Endoscopic treatment of symptomatic VUR in transplanted kidney is a safe and feasible procedure. The amount of bulking agent or duration between the transplantation and diagnosis of VUR does not have any impact on the success of the treatment. However, the younger age of the patients and the female gender seem to have a positive efect on the outcome of the procedure.
SourceClinical and Experimental Nephrology
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