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The Swedish Reflux Trial in Children: V. Bladder Dysfunction.

Sillén, Ulla; Brandström, Per; Jodal, Ulf; Holmdahl, Gundela; Sandin, Anders; Sjöberg, Ingrid LU and Hansson, Sverker (2010) In The Journal of urology 184. p.298-304
Abstract
PURPOSE: We investigated the prevalence and types of lower urinary tract dysfunction in children with vesicoureteral reflux grades III and IV, and related improved dilating reflux, renal damage and recurrent urinary tract infection to dysfunction. MATERIALS AND METHODS: A total of 203 children between ages 1 to less than 2 years with reflux grades III and IV were recruited into this open, randomized, controlled, multicenter study. Voiding cystourethrography and dimercapto-succinic acid scintigraphy were done at study entry and 2-year followup. Lower urinary tract function was investigated by noninvasive methods, at study entry with 4-hour voiding observation in 148 patients and at 2 years by structured questionnaire and post-void residual... (More)
PURPOSE: We investigated the prevalence and types of lower urinary tract dysfunction in children with vesicoureteral reflux grades III and IV, and related improved dilating reflux, renal damage and recurrent urinary tract infection to dysfunction. MATERIALS AND METHODS: A total of 203 children between ages 1 to less than 2 years with reflux grades III and IV were recruited into this open, randomized, controlled, multicenter study. Voiding cystourethrography and dimercapto-succinic acid scintigraphy were done at study entry and 2-year followup. Lower urinary tract function was investigated by noninvasive methods, at study entry with 4-hour voiding observation in 148 patients and at 2 years by structured questionnaire and post-void residual flow measurement in 161. RESULTS: At study entry 20% of patients had lower urinary tract dysfunction, characterized by high bladder capacity and increased post-void residual urine. At 2 years there was dysfunction in 34% of patients. Subdivision into groups characteristic of children after toilet training revealed that 9% had isolated overactive bladder and 24% had voiding phase dysfunction. There was a negative correlation between dysfunction at 2 years and improved dilating reflux (p = 0.002). Renal damage at study entry and followup was associated with lower urinary tract dysfunction at 2 years (p = 0.001). Recurrent urinary tract infections were seen in 33% of children with and in 20% without dysfunction (p = 0.084). CONCLUSIONS: After toilet training a third of these children with dilating reflux had lower urinary tract dysfunction, mainly voiding phase problems. Dysfunction was associated with persistent reflux and renal damage while dysfunction at study entry did not predict the 2-year outcome. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The Journal of urology
volume
184
pages
298 - 304
publisher
Lippincott Williams & Wilkins
external identifiers
  • WOS:000278642300105
  • PMID:20488486
  • Scopus:77953230627
ISSN
1527-3792
DOI
10.1016/j.juro.2010.03.063
language
English
LU publication?
yes
id
ba727063-f4f7-4967-95c4-a6fd82cc7d55 (old id 1610076)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20488486?dopt=Abstract
date added to LUP
2010-06-02 11:19:01
date last changed
2017-01-01 07:48:54
@article{ba727063-f4f7-4967-95c4-a6fd82cc7d55,
  abstract     = {PURPOSE: We investigated the prevalence and types of lower urinary tract dysfunction in children with vesicoureteral reflux grades III and IV, and related improved dilating reflux, renal damage and recurrent urinary tract infection to dysfunction. MATERIALS AND METHODS: A total of 203 children between ages 1 to less than 2 years with reflux grades III and IV were recruited into this open, randomized, controlled, multicenter study. Voiding cystourethrography and dimercapto-succinic acid scintigraphy were done at study entry and 2-year followup. Lower urinary tract function was investigated by noninvasive methods, at study entry with 4-hour voiding observation in 148 patients and at 2 years by structured questionnaire and post-void residual flow measurement in 161. RESULTS: At study entry 20% of patients had lower urinary tract dysfunction, characterized by high bladder capacity and increased post-void residual urine. At 2 years there was dysfunction in 34% of patients. Subdivision into groups characteristic of children after toilet training revealed that 9% had isolated overactive bladder and 24% had voiding phase dysfunction. There was a negative correlation between dysfunction at 2 years and improved dilating reflux (p = 0.002). Renal damage at study entry and followup was associated with lower urinary tract dysfunction at 2 years (p = 0.001). Recurrent urinary tract infections were seen in 33% of children with and in 20% without dysfunction (p = 0.084). CONCLUSIONS: After toilet training a third of these children with dilating reflux had lower urinary tract dysfunction, mainly voiding phase problems. Dysfunction was associated with persistent reflux and renal damage while dysfunction at study entry did not predict the 2-year outcome.},
  author       = {Sillén, Ulla and Brandström, Per and Jodal, Ulf and Holmdahl, Gundela and Sandin, Anders and Sjöberg, Ingrid and Hansson, Sverker},
  issn         = {1527-3792},
  language     = {eng},
  pages        = {298--304},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {The Journal of urology},
  title        = {The Swedish Reflux Trial in Children: V. Bladder Dysfunction.},
  url          = {http://dx.doi.org/10.1016/j.juro.2010.03.063},
  volume       = {184},
  year         = {2010},
}