TY - JOUR AU - Wang, Peter (Zhan Tao) AU - Abdelhalim, Ahmed AU - Walia, Arman AU - Wehbi, Elias AU - Dave, Sumit AU - Khoury, Antoine PY - 2018/11/05 Y2 - 2024/03/28 TI - Avoiding routine postoperative voiding cystourethrogram: Predicting radiologic success for endoscopically treated vesicoureteral reflux JF - Canadian Urological Association Journal JA - CUAJ VL - 13 IS - 5 SE - Original Research DO - 10.5489/cuaj.5589 UR - https://cuaj.ca/index.php/journal/article/view/5589 SP - AB - <p><strong>Introduction:</strong> Variability in the success rates for the endoscopic correction of vesicoureteral reflux (VUR) has prompted a debate regarding the use of routine postoperative voiding cystourethrogram (VCUG). This study examines the predictive performance of intraoperative mound morphology (IMM) and the presence of a postoperative ultrasound mound (PUM) on radiologic success, as well as investigates the role of using these two predictive factors as a composite tool to predict VUR resolution after endoscopic treatment.</p><p><strong>Methods:</strong> This retrospective study included children with primary VUR who underwent endoscopic correction with a double hydrodistension-implantation technique (HIT) and dextranomer/ hyaluronic acid copolymer. IMM was assessed intraoperatively. The presence of a PUM and VUR resolution were assessed by postoperative ultrasound (US) and VCUG, respectively. Radiologic success was defined as VUR resolution.</p><p><strong>Results:</strong> A total of 70 children (97 ureters) were included in the study. The overall radiologic success rate was 83.5%. There was no statistically significant association between radiologic success and IMM (85.2% with excellent and 87.5% with “other” morphology; p=0.81). The sensitivity and specificity of PUM for radiologic success in this study was 98% and 71%, respectively, while the sensitivity and specificity of the combined prediction model were 81.9% and 85.7%, respectively.</p><p><strong>Conclusions:</strong> We objectively demonstrated that IMM was a poor predictor of radiologic success and should be used with caution. In addition, the performance of a combined prediction model was inferior to the presence of a PUM alone. As such, selective use of postoperative VCUG may be guided solely by the presence of a PUM.</p> ER -