Re: Moore et al.: Treatment of Vesicoureteral Reflux in Adults by Endoscopic Injection (Urology 2011;77: 1284-1287)

摘要

We congratulate the authors on the excellent study. The results suggest that the STING procedure or its hydro-distention implantation (HIT) modification, being patient friendly, simple to perform and comparably effective, may be the treatment of choice for adult primary vesicoureteral reflux (VUR). We wish to offer our comments on the study.By and large, recurrent pyelonephritis formed the basis for inclusion (except in 1 patient, for whom the symptom was not mentioned). Although, as the authors mention, "no long term studies have documented the natural history of uncorrected reflux after puberty," it is not unreasonable to assume that, as in children, renal function will continue to deteriorate in untreated adult cases too, because of scarring induced by recurrent pyelonephritis or the intrarenal reflux per se.