Intraoperative ultrasound-assisted approach for endoscopic treatment of...

The study by Zambaidi and colleagues analyzed a cohort of children treated for moderate to high grade primary vesicoureteral reflux with dextronomer hyaluronic acid

Patients undergoing injection underwent concomitant intraoperative ultrasound evaluation by a trained radiologist to evaluate mound location, mound height, and mound classification

Mound classification was described as poor, good, and optimal based on several criteria

At 3 months, all patients underwent VCUG and renal bladder ultrasound, with subsequent follow-up renal bladder ultrasound at 1 year

Follow-up imaging was performed by a radiologist blinded to the initial study

The study included 26 patients amounting to 41 ureters

61% of injections used the double hit technique and 39% used the sting technique

Overall success per ureter radiographically was 75.6%

Multivariate regression showed a correlation between success and mound height, consistent with previous studies

A mound height of greater or equal to 9.8 millimeters was a predictor of reflux resolution

The authors proposed a follow-up algorithm in which patients with high resolution rates based on favorable mound anatomy underwent simple clinical monitoring or ultrasound scan without a VCUG