Scholtmeijer R J, Griffiths D J
Department of Paediatric Urology, Erasmus University, Rotterdam, The Netherlands.
J Pediatr Surg. 1990 Jun;25(6):669-71. doi: 10.1016/0022-3468(90)90359-h.
From January 1986 to January 1988, 63 children with 95 refluxing ureters have been studied in a prospective study with videourodynamic examination. All children with reflux grades I, II, and III received antibacterial treatment. Surgical treatment was adopted for reflux grades IV and V, provided detrusor instability had been excluded. However, if there was detrusor instability, anticholinergic drugs and antibacterial treatment were given in all grades of reflux and videourodynamic examination was repeated after 3 to 6 months and after 12 months of therapy. Bilateral reflux was found in 22 of 38 patients with a stable bladder, and reimplantation was performed in 11 patients with 18 refluxing ureters. In 25 children with 35 refluxing ureters of various grades of reflux, detrusor instability was found and unilateral reflux was noted more frequently than bilateral reflux. Surgery was necessary for only five children, because in the majority of the patients detrusor instability and reflux could be treated by anticholinergic drugs and antibacterial treatment. For the decision as to which treatment should be given in vesicoureteral reflux, a videourodynamic study is mandatory.
1986年1月至1988年1月，对63例患有95条反流输尿管的儿童进行了一项前瞻性视频尿动力学检查研究。所有I、II和III级反流的儿童均接受抗菌治疗。IV级和V级反流采用手术治疗，前提是已排除逼尿肌不稳定。然而，如果存在逼尿肌不稳定，则在所有反流级别中给予抗胆碱能药物和抗菌治疗，并在治疗3至6个月后以及12个月后重复进行视频尿动力学检查。在38例膀胱稳定的患者中，22例发现双侧反流，11例患有18条反流输尿管的患者进行了再植术。在25例患有不同反流级别的35条反流输尿管的儿童中，发现了逼尿肌不稳定，单侧反流比双侧反流更常见。仅5名儿童需要手术，因为大多数患者的逼尿肌不稳定和反流可以通过抗胆碱能药物和抗菌治疗来治疗。对于决定在膀胱输尿管反流中应给予何种治疗，视频尿动力学研究是必不可少的。
