Clinical management of vesicoureteral reflux with respect to EAU
Guidelines: A multicenter study
Abstract
Purpose: We designed a multicenter, retrospective study to investigate
the current trends in initial management of reflux with respect to EAU
guidelines in Urology clinics of our country. Materials and Methods: The
study group consisted of 1988 renal units (RU) of 1345 patients treated
surgically due to VUR between years 2003-2017 in 9 different
institutions. Patients were divided into 2 groups according to time of
initial treatment and also grouped according to risk factors by “EAU
guidelines on VUR”. Results: 1426 RUs were treated initially
conservatively and 562 RUs were initially treated with surgery. In
initially surgically treated group, success rates of surgery decreased
significantly in low and moderate risk groups after 2013 (p=0.046,
p=0.0001, respectively), while success rates were not significantly
different in high risk group (p=0.46). While 26.6% of patients in low
risk group were initially surgically treated before 2013, this rate has
increased to 34.6% after 2013, but the difference was not statistically
significant (p=0.096). However, performing surgery as the initial
treatment approach increased significantly in both moderate and high
risk groups (p=0.000 and p=0.0001, respectively) after 2013. Overall
success rates of endoscopic and UNC operations were 65% and 92.9%
before 2013, 60% and 78.5% after 2013, respectively. Thus the overall
success rate for surgery was 72.6%. There was significant difference
between success rates of UNC operations before and after 2013(p=0.000),
while the difference was not significant in the STING group (p=0.076).
Conclusion: Current trends in management of reflux in our country do not
yet follow the EAU guidelines on VUR in low and moderate risk groups.