Varol Alkım Tolga, Caylan Ahmet Ender, Uçar Murat
Department of Urology, Akdeniz University School of Medicine, Antalya, Turkey.
BMC Urol. 2025 Apr 16;25(1):92. doi: 10.1186/s12894-025-01779-7.
Predicting the success of endoscopic treatment of VUR in transplant patients may not only protect both the physician and the patient from unnecessary investigations and treatment but may also prolong the life of the graft by preventing possible loss of time.
This retrospective study included 116 patients with vesicoureteral reflux following kidney transplantation between 2014-2022. Demographic data, preoperative and intraoperative clinical aspects, and postoperative 6-month success rates were evaluated.
The success rate of the injection treatment in the 6 month was 41.4%. As the patient age decreased, the success rate of the injection decreased (p = 0.025). While no significant relationship was observed between the preoperative reflux grade, injected volume of the bulking agent, and success (p = 0.109 and 0.222, respectively), a significant decrease in success was observed with an increase in UDR (p < 0.001) in group comparison. Regression analyses demonstrated that pre-injection visual assessment and post-injection orifice mound view influenced the success rate (p < 0.001 and p < 0.001, respectively).
Intraoperative visual assessment of the orifice is a reliable indicator for predicting the success of subureteric injection. It not only provides patients with trustworthy postoperative information but also saves clinicians time by anticipating the next surgical stage, ultimately contributing to the prolongation of graft life.
预测移植患者膀胱输尿管反流内镜治疗的成功率，不仅可以使医生和患者避免不必要的检查和治疗，还可以通过防止可能的时间浪费来延长移植物的寿命。
这项回顾性研究纳入了2014年至2022年间116例肾移植后发生膀胱输尿管反流的患者。评估了人口统计学数据、术前和术中的临床情况以及术后6个月的成功率。
注射治疗6个月时的成功率为41.4%。随着患者年龄的降低，注射成功率也降低（p = 0.025）。虽然术前反流分级、填充剂注射量与成功率之间未观察到显著相关性（p分别为0.109和0.222），但在组间比较中，随着UDR的增加，成功率显著降低（p < 0.001）。回归分析表明，注射前视觉评估和注射后孔口隆起视图影响成功率（p分别< 0.001和p < 0.001）。
术中对孔口的视觉评估是预测输尿管下注射成功率的可靠指标。它不仅为患者提供了可信的术后信息，还通过预测下一手术阶段节省了临床医生的时间，最终有助于延长移植物寿命。
