I. Ulman et al., IS RESOLUTION OF VESICOURETERAL REFLUX BY CONSERVATIVE MANAGEMENT PREDICTABLE IN PATIENTS WITH MYELODYSPLASIA, European urology, 34(3), 1998, pp. 226-229
Objective: To evaluate the probable factors that might predict the out
come of conservative management of vesicoureteric reflux (VUR) in myel
odysplastic patients, Patients and Methods: A retrospective review of
24 children with VUR secondary to neurogenic bladder (l5 girls and 9 b
oys, age range 1-18 years) out of 75 myelodysplasia patients between 1
994 and 1996 was made, Patients were grouped according to their respon
se to conservative management: Group I: patients with their VUR resolv
ed or downgraded (n = 15), and group II: patients with their VUR uncha
nged or increased (n = 9), The following parameters were compared betw
een the two groups: age, sex, VUR grade and laterality, urodynamic par
ameters (bladder capacity, compliance, leak point pressure), type of b
ladder neuropathy, accompanying neuropathology (walking problem, anal
incontinence), Results: Most of the parameters studied failed to predi
ct the outcome of conservative management of VUR in patients with neur
ogenic bladder dysfunction, Higher grades of VUR if bilateral seem to
benefit more from conservative management than lower grades do, Conser
vative management appears to be more effective in hyperreflexic bladde
rs than areflexic bladders in terms of VUR resolution, Conclusion: Alt
hough prediction of patients resistant to conservative management of V
UR could save myelodysplastic children from prolonged risk of renal da
mage, current methods of evaluation are of very little help in this as
pect.