Meu SciELO
Serviços customizadosServiços Personalizados
Journal
Artigo
Espanhol (pdf)
Artigo em XML
Referências do artigo
Tradução automática
Enviar este artigo por emailIndicadores
Citado por SciELO 
Acessos
Links relacionados
Citado por Google 
Similares em
SciELO 
Similares em Google
Compartilhar
Permalink
Actas Urológicas Españolas
versão impressa ISSN 0210-4806
Resumo
PONCE DIAZ-REIXA, J. et al. Vesicoureteral reflux in spinal cord injured patients: Treatment results and statistical analysis. Actas Urol Esp [online]. 2007, vol.31, n.4, pp.366-371. ISSN 0210-4806.
Introduction: VUR in spinal cord injured patients is cause of important morbidity and mortality. The aim of this paper is to make a statistical, retrospective and descriptive study to analyze VUR treatment results, in neurogenic bladder SCI patients. Material and method: We study 40 patients (80 renal units) with VUR in neurogenic bladders and SCI, between March, 1990 and November, 2004. Median age is 43.05 y (9-76). 77.5% of patients are males (3.4:1). Time from injury to VUR is 24.7m (0.2-87). Median follow up is 8.23a (0.5-29). Traumatic lesions are most frequent (70%). Median bladder capacity is 244.9 ml (43-555) and median bladder compliance is 16.12 ml/cm H20 (0.3-61.6). Detrusor overactivity is found in 72.2% and detrusor-sphincter dyssynergiain 71.8%. Initial conservative treatment is done with indwelling catheter and anticholinergics Results: Complete remission was found in 57.5% of RU, descending VUR a 23.7% (66.2% previously to 42.5% after; p<0.02), and predominant in unilateral reflux. Partial response was found in 3.8%, progression in 12.5% and recidiva post CR in 10.9%. Younger patients have better remission rates (39.4 to 47.6 y; p=0.04). Urodinamycs variables dont found any significant differences in treatment results. Endoscopic treatment with bulking agents gets a good response rate (56.3%) (p=0.18). Conclusions: Initial conservative treatment gets a 23.7% reduction of VUR, especially in men, young and unilateral reflux patients. Anyhow, we observe some progression and recidiva. Detrusor overactivity and detrusor-sphincter dyssynergia didnt influence in treatment results, but they are found in all patients with recidiva. With longer reflux evolution, we observe better responses, but also a higher recidiva rate (p=0.007). Endoscopic bulky injection techniques found out a good response rate (56.3%), also in patients with recidiva after conservative treatment.
Palavras-chave : Vesicoureteral reflux; Neurogenic bladder; Conservative treatment.
