An evaluation of ureteral diameter ratio and vesicoureteral reflux index in the treatment of primary vesicoureteral reflux

doi:10.1016/j.ajur.2023.05.007

Asian Journal of Urology, 2024, 11 (3): 437-442 doi: 10.1016/j.ajur.2023.05.007

Regular Papers: Original Articles

An evaluation of ureteral diameter ratio and vesicoureteral reflux index in the treatment of primary vesicoureteral reflux

Yusuf Atakan Baltrak^*(

),Nebil Akdoğan,Mutlu Değer,Volkan Izol,Ibrahim Atilla Aridoğan,Nihat Satar

Division Pediatric Urology, Department of Urology, Medical Faculty, Cukurova University, Adana, Turkey

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Abstract

Objective: Vesicoureteral reflux (VUR) index is a simple, validated tool that reliably predicts significant improvement and spontaneous resolution of primary reflux in children. The aim of this study was to evaluate and compare the ureter diameter ratio (UDR) and VUR index (VURx) of patients treated with endoscopic injection (EI) and ureteroneocystostomy (UNC) methods in the pediatric age group due to primary VUR.

Methods: Patients under the age of 18 years old who underwent EI and UNC with the diagnosis of primary VUR between January 2011 and September 2021 were determined as the participants. The UDR was assessed using voiding cystourethrography, and the VURx score was determined prior to treatment based on hospital records included in the study.

Results: A total of 255 patients, 60 (23.5%) boys and 195 (76.5%) girls, with a mean age of 76.5 (range 13.0-204.0) months, were included in the study. EI was applied to 130 (51.0%) patients and UNC was applied to 125 (49.0%) patients due to primary VUR. The optimum cut-off for the distal UDR was obtained as 0.17 with sensitivity and specificity of 73.0% and 63.0%, respectively. The positive and negative predictive values were 66.0% and 70.0%, respectively.

Conclusion: When the UDR and VURx score are evaluated together for the surgical treatment of primary VUR in the pediatric age group, it is thought that it may be useful in predicting the clinical course of the disease and evaluating surgical treatment options.

Key words： Distal ureter diameter ratio Vesicoureteral reflux Vesicoureteral reflux index management Vesicoureteral reflux index

Received: 16 July 2022 Available online: 20 July 2024

Corresponding Authors: *E-mail address: dratakanbaltrak@gmail.com (Y.A. Baltrak).

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	Yusuf Atakan Baltrak
	Nebil Akdoğan
	Mutlu Değer
	Volkan Izol
	Ibrahim Atilla Aridoğan
	Nihat Satar

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Cite this article:

Yusuf Atakan Baltrak,Nebil Akdoğan,Mutlu Değer, et al. An evaluation of ureteral diameter ratio and vesicoureteral reflux index in the treatment of primary vesicoureteral reflux[J]. Asian Journal of Urology, 2024, 11(3): 437-442.

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http://www.ajurology.com/EN/10.1016/j.ajur.2023.05.007 OR http://www.ajurology.com/EN/Y2024/V11/I3/437

The demographic information of the patients and VURx.

Findings of the patients who had EI and UNC because of primary vesicoureteral reflux.

Comparative results of EI and UNC groups.

VURx score and UDR comparison between EI and UNC groups.

Multivariate logistic regression analysis results of the patients who had UNC after EI (n=21).

The box plot of ureteral diameter ratio in UNC and EI groups. UNC, ureteroneocystostomy; EI, endoscopic injection. ?? p<0.001.

The receiver operating characteristic curve analysis of ureter diameter ratio predicts ureteroneocystostomy AUC. AUC, area under the curve; CI, confidence interval.

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