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기능적 배뇨장애가 방광요관역류 및 신반흔에 미치는 영향

Other Titles
 The Impact of Voiding Dysfunction on Vesicoureteral Reflux and Renal Scars 
 임영재  ;  전형진  ;  한상원 
 KOREAN JOURNAL OF UROLOGY, Vol.46(9) : 897-902, 2005 
Journal Title
Issue Date
Dysfunction ; Urodynamics ; Vesico-ureteral reflux ; Scars
Dysfunction ; Urodynamics ; Vesico-ureteral reflux ; Scars
Purpose: To report the relationship between voiding dysfunction and reflux, renal scars and the common findings related to voiding dysfunction in patients with vesico-ureteral reflux (VUR). Materials and Methods: Between March 2002 and February 2004, 56 children underwent a video-urodynamic study (video-UDS) for evaluation of VUR. The grade of VUR, various findings of voiding dysfunction and the maximal intravesical pressure (maxPves) were assessed during voiding, and severity of renal scars were assessed via video-UDS and DMSA scans, respectively. Results: Voiding dysfunction was diagnosed in 30 patients (53.6%). The findings of voiding dysfunction were uninhibited contraction (14 patients), detrusor sphincter dyssynergia (15 patients) and bladder neck opening during the filling phase (17 patients). Urethrovaginal reflux and after contraction were noted in 6 and 8 patients, respectively. In the voiding dysfunction group, the mean VUR grade was 3.4, while this was 2.6 in 42 renal units of the normal voiding group (p=0.023). The mean maxPves values during voiding in the voiding dysfunction and normal voiding groups were 107.7 and 77cmH2O, respectively (p=0.002). On evaluation of the relationship between voiding dysfunction and the extent of renal scarring [no scar, single scar, multiple scars, reduced size], the existence of voiding dysfunction resulted in more severe forms of renal scarring (p=0.034). Conclusions: Voiding dysfunction can cause or aggravate VUR or urinary tract infection due to an increased intravesical pressure during voiding, which can ultimately cause permanent renal damage. Therefore, treatments, such as anticholinergic drugs or biofeedback, must be performed in patients with combined VUR and voiding dysfunction for a better treatment outcome.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Jeon, Hyung Jin(전형진)
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
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