Voiding dysfunction (VD) increases the frequency of vesicoureteral reflux (VUR). Subureteric injection is an effective method for the treatment; however, the presence of VD may affect the success rates. This study evaluated the results of single-session endoscopic treatment in patients admitting with VD symptoms who were diagnosed with VUR, and the effect of compliance to VD treatment on these results.
The data regarding patients who were being followed up for non-neurogenic VD diagnosis and who underwent subureteric injection or treated conservatively was reviewed retrospectively in terms of follow up information and surgical outcomes. Endoscopic treatment was performed by applying dextranomer/hyaluronic acid copolymer via submucosal route. Symptomatic and radiological assessments of the patients on month 3 were reviewed.
The data of 45 patients (67 renal unites (RU)) were assessed. 24 of them treated conservatively 21 of them underwent endoscopic subureteric injection (STING). STING was performed for Grade 1 VUR in 3 RU, grade 2 in 12 RU, grade 3 in 16 RU, grade 4 in 2 RU, and grade 5 in 2 RU. The success rate after subureteric injection treatment was found to be 68%. VD treatment incompliance rate was detected to be 31%, and infection rate during follow-up after injection to be 24%.
Providing regular treatment for voiding dysfunction for at least 6 months before the endoscopic injection treatment for VUR accompanied by VD is important for increasing the success rates. That being said, the success rate in this group might be lower than expected despite proper treatment for bladder.