Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Konkret geht es um den Diabetes-Patienten mit kardiovaskulären Erkrankungen oder Risiken, die Herzinsuffizienz sowie die kardiovaskuläre Primär- und Sekundärprävention. Sind Sie hier schon auf dem neuesten Stand? Unsere Experten beleuchten, wo und warum das bisherige Procedere geändert werden soll und was in der Praxis sinnvoll ist. Holen Sie sich Ihr Update und 2 CME-Punkte beim MMW-Webinar am 24. April von 17.30 bis 19 Uhr. 
Erweiterte Suche
Anmelden
nach oben
Current Bladder Dysfunction Reports
Erschienen in: Current Bladder Dysfunction Reports 3/2017

03.07.2017 | Pediatric Bladder Dysfunction (SJ Hodges, Section Editor)

Endoscopic Treatment of Vesicoureteral Reflux

verfasst von: Angela M. Arlen, Andrew J. Kirsch

Erschienen in: Current Bladder Dysfunction Reports | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Optimal management of primary vesicoureteral reflux (VUR) remains a source of debate, and options include observation with or without continuous antibiotic prophylaxis and surgical repair via endoscopic, open, or laparoscopic/robotic approaches. Surgical intervention may be necessary in children with persistent reflux, renal scarring, or recurrent febrile urinary tract infections when other options fail.

Recent Findings

Need for surgical correction is dictated predominantly by a given child’s clinical course including risk for recurrent infections and potential for renal scarring. While recent studies suggest that endoscopic injection is effective for the treatment of most VUR, the importance of material injected, technique utilized, reflux grade, and structural/functional bladder anomalies on ultimate success rates must be emphasized.

Summary

Long-term clinical success following endoscopic correction of primary VUR is high, and the majority of children avoid additional or more invasive surgical procedures. Efficacy rates are known to vary widely between surgeons, techniques, and implant materials.
Literatur
1.
Sargent MA. What is the normal prevalence of vesicoureteral reflux? Pediatr Radiol. 2000;30:587–93.CrossRefPubMed
2.
Skoog SJ, Peters CA, Arant BS Jr, Copp HL, Elder JS, Hudson RG, et al. Pediatric vesicoureteral reflux guideline panel summary report: clinical practice guidelines for screening siblings of children with vesicoureteral reflux and neonates/infants with prenatal hydronephrosis. J Urol. 2010;184:1145–51.CrossRefPubMed
3.
Nguyen HT, Herndon CD, Cooper C, Gatti J, Kirsch A, Kokorowski P, et al. The Society for Fetal Urology consensus statement on the evaluation and management of antenatal hydronephrosis. J Pediatr Urol. 2010;6:212–31.CrossRefPubMed
4.
5.
Koyle M, Kirsch A, Barone C, Elder J, Shifrin D, Skoog S, et al. Challenges in childhood urinary tract infection/vesicoureteral reflux investigation and management: calming the storm. Urology. 2012;80:503–8.CrossRefPubMed
6.
Matouschek E. Die Behandlung des vesikorenalen Refluxes durch transurethrale Einspritzung von Teflonpaste. Der Urologe Ausgabe A. 1981;20:263–4.
7.
O’Donnell B, Puri P. Treatment of vesicoureteric reflux by endoscopic injection of Teflon. Br Med J (Clin Res). 1984;289:7–9.CrossRef
8.
Ormaechea M, Ruiz E, Denes E, Gimenez F, Dénes FT, Moldes J, et al. New tissue bulking agent (polyacrylate polyalcohol) for treating vesicoureteral reflux: preliminary results in children. J Urol. 2010;183(2):714–7.CrossRefPubMed
9.
Kirsch AJ, Perez-Brayfield M, Smith EA, Scherz HC. The modified STING procedure to correct vesicoureteral reflux: improved results with submucosal implantation within the intramural ureter. J Urol. 2004;171:2413–6.CrossRefPubMed
10.
Kalisvaart JF, Scherz HC, Cuda S, Kaye JD, Kirsch AJ. Intermediate to long-term follow-up indicates low risk of recurrence after double HIT endoscopic treatment for primary vesicoureteral reflux. J Pediatr Urol. 2012;8:359–65.CrossRefPubMed
11.
Kocherov S, Ulman I, Nikolaev S, Corbetta JP, Rudin Y, Slavkovic A, et al. Multicenter survey of endoscopic treatment of vesicoureteral reflux using polyacrylate-polyalcohol bulking copolymer (Vantris). Urology. 2014;84:689–93.CrossRefPubMed
12.
Trial Investigators RIVUR, Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, et al. Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 2014;19:2367–76.CrossRef
13.
Knudson MJ, Austin JC, McMillan ZM, Hawtrey CE, Cooper CS. Predictive factors of early spontaneous resolution in children with primary vesicoureteral reflux. J Urol. 2007;178:1684–8.CrossRefPubMed
14.
Martin AD, Iqbal MW, Sprague BM, Diaz M, Rushton HG, Peters CA, et al. Most infants with dilating vesicoureteral reflux can be treated nonoperatively. J Urol. 2014;191:1620–6.CrossRefPubMed
15.
Arlen AM, Garcia-Roig M, Weiss AD, Leong T, Cooper CS, Kirsch AJ. Vesicoureteral reflux index: 2-institution analysis and validation. J Urol. 2016;195:1294–9.CrossRefPubMed
16.
Mak RH, Kuo HJ. Pathogenesis of urinary tract infection: an update. Curr Opin Pediatr. 2006;18:148–52.CrossRefPubMed
17.
Peters CA, Skoog SJ, Arant BS Jr, Copp HL, Elder JS, Hudson RG, et al. Summary of the AUA guideline on management of primary vesicoureteral reflux in children. J Urol. 2010;184:1134–44.CrossRefPubMed
18.
Sung J, Skoog S. Surgical management of vesicoureteral reflux in children. Pediatr Nephrol. 2012;27:551–61.CrossRefPubMed
19.
Elder JS, Peters CA, Arant BS Jr, Ewalt DH, Hawtrey CE, Hurwitz RS, et al. Pediatric vesicoureteral reflux guidelines panel summary report on the management of primary vesicoureteral reflux in children. J Urol. 1997;157:1846–51.CrossRefPubMed
20.
Alexander SE, Arlen AM, Storm DW, Kieran K, Cooper CS. Bladder volume at onset of vesicoureteral reflux is an independent risk factor for breakthrough febrile urinary tract infection. J Urol. 2015;193:1342–6.CrossRefPubMed
21.
Routh JC, Bogaert GA, Kaefer M, Manzoni G, Park JM, Retik AB, et al. Vesicoureteral reflux: current trends in diagnosis, screening, and treatment. Eur Urol. 2012;61:773–82.CrossRefPubMed
22.
Kurtz MP, Leow JJ, Varda BK, Logvinenko T, McQuaid JW, Yu RN, et al. The decline of the open ureteral reimplant in the United States: national data from 2003 to 2013. Urology. 2017;100:193–7.CrossRefPubMed
23.
Nordenström J, Holmdahl G, Brandström P, Sixt R, Stokland E, Sillén U, et al. The Swedish infant high-grade reflux trial: study presentation and vesicoureteral reflux outcome. J Pediatr Urol 2016
24.
Häcker FM, Frech-Dörfler M, von Rotz M, Rudin C. Endoscopic hyaluronic acid/dextranomer gel implantation is effective as first-line treatment of vesicoureteral reflux (VUR) in children: a single centre experience. Eur J Pediatr Surg. 2011;21:299–303.CrossRefPubMed
25.
Lackgren G, Kirsch AJ. Endoscopic treatment of vesicoureteral reflux. BJUI. 2010;105:1332–47.CrossRef
26.
Cerwinka W, Scherz HC, Kirsch AJ. Dynamic hydrodistention classification of the ureter and the double HIT method to correct vesicoureteral reflux. Arch Esp Urol. 2008;61:882–7.CrossRefPubMed
27.
Chertin B, Arafeh WA, Zeldin A, Kocherov S. Preliminary data on endoscopic treatment of vesicoureteric reflux with polyacrylate polyalcohol copolymer (Vantris®): surgical outcome following single injection. J Pediatr Urol. 2011;7:654–7.CrossRefPubMed
28.
Sharifiaghdas F, Tajalli F, Otukesh H, Shamsabadi RH. Endoscopic correction of primary VUR by using polyacrylate polyalcohol copolymer (Vantris) in young girls: 2-year follow-up. J Pediatr Urol. 2014;10:1032–6.CrossRefPubMed
29.
•• Kocherov S, Ulman I, Nikolaev S, Corbetta JP, Rudin Y, Slavkovic A, et al. Multicenter survey of endoscopic treatment of vesicoureteral reflux using polyacrylate-polyalcohol bulking copolymer (Vantris). Urology. 2014;84:689–93. Multicenter review of 611 children treated with Vantris ® for primary and secondary vesicoureteral reflux; 93.8% had complete resolution after a single infection. No late recurrences (3years) were observed during prospective follow-up CrossRefPubMed
30.
Warchol S, Krzemien G, SzmigielskaA, Bombinski P, BrzewskiM, Dudek-Warchol T. Comparison of results of endoscopic correction of vesicoureteral reflux in children using two bulking substances: dextranomer/hyaluronic acid copolymer (Deflux) versus polyacrylate-polyalcohol copolymer (Vantris). J Pediatr Urol. 2016;12:256.e1–4.
31.
Chertin B, Arafeh WA, Zeldin A, Ostrovsky IA, Kocherov S. Endoscopic correction of VUR using Vantris as a new non-biodegradable tissue-augmenting substance: three years of prospective follow-up. Urology. 2013;82:201–4.CrossRefPubMed
32.
Kaye JD, Srinivasan AK, Delaney C, Cerwinka WH, Elmore JM, Scherz HC, et al. Clinical and radiographic results of endoscopic injection for vesicoureteral reflux: defining measures of success. J Pediatr Urol. 2012;8:297–303.CrossRefPubMed
33.
Yap TL, Chen Y, Nah SA, Ong CC, Jacobsen A, Low Y. STING versus HIT technique of endoscopic treatment for vesicoureteral reflux: a systematic review and meta-analysis. J Pediatr Surg. 2016;51:2015–20.CrossRefPubMed
34.
Akin M, Erginel B, Karadag CA, Yildiz A, Ozçelik GS, Sever A, et al. A comparison of the double hydrodistention implantation technique (HIT) and the HIT with a polyacrylate/polyalcohol copolymer (PPC) for the endoscopic treatment of primary vesicoureteral reflux. Int Urol Nephrol. 2014;46:2057–61.CrossRefPubMed
35.
Kirsch AJ, Arlen AM, Lackgren G. Current trends in dextranomer hyaluronic acid copolymer (Deflux) injection technique for endoscopic treatment of vesicoureteral reflux. Urology. 2014;84:462–8.CrossRefPubMed
36.
Kirsch AJ, Kaye JD, Cerwinka WH, Watson JM, Elmore JM, Lyles RH, et al. Dynamic hydrodistention of the ureteral orifice: a novel grading system with high interobserver concordance and correction with vesicoureteral reflux grade. J Urol. 2009;182:1688–92.CrossRefPubMed
37.
• Arlen AM, Broderick KM, Huen KH, Leong T, Scherz HC, Kirsch AJ. Temporal pattern of vesicoureteral reflux on voiding cystourethrogram correlates with dynamic endoscopic hydrodistention grade of ureteral orifice. J Urol. 2014;192:1503–7. Study demonstrating that VUR occurring early in the bladder cycle is associated with anatomically incompetent ureteral orifices as evidenced by abnormal ureteral hydrodistention, which also correlates with higher VUR grades and decreased rate of reflux resolution. These findings emphasize the importance of maximizing information obtaining from VCUG by noting the timing of VUR onset CrossRefPubMed
38.
Zambaiti E, Pensabene M, Montano V, Casuccio A, Sergio M, Cimador M. Ultrasonographic mound height as predictor of vesicoureteral reflux resolution after endoscopic treatment in children. J Pediatr Surg. 2016;51:1366–9.CrossRefPubMed
39.
Arlen AM, Scherz HC, Filimon E, Leong T, Kirsch AJ. Is routine voiding cystourethrogram necessary following double hit for primary vesicoureteral reflux? J Pediatr Urol. 2015;11:40.e1–5.CrossRef
40.
García-Aparicio L, Blázquez-Gómez E, Vila Santandreu A, Camacho Diaz JA, Vila-Cots J, Ramos CM. Routine delayed voiding cystourethography after initial successful endoscopic treatment with dextranomer/hialuronic acid copolimer (Dx/HA) of vesicoureteral reflux (VUR). Is it necessary? Actas Urol Esp. 2016;40:635–9.CrossRefPubMed
41.
Elder JS, Diaz M, Caldamone AA, Cendron M, Greenfield S, Hurwitz R, et al. Endoscopic therapy for vesicoureteral reflux: a meta-analysis. I. Reflux resolution and urinary tract infection. J Urol. 2006;175:716–22.CrossRefPubMed
42.
Capozza N, Lais A, Nappo S, Caione P. The role of endoscopic treatment of vesicoureteral reflux: a 17-year experience. J Urol. 2004;172(4 Pt 2):1626–8.CrossRefPubMed
43.
Kirsch A, Hensle T, Scherz H, Koyle M. Injection therapy: advancing the treatment of vesicoureteral reflux. J Pediatr Urol. 2006;2(6):539–44.CrossRefPubMed
44.
Yu RN, Jones EA, Roth DR. Renal ultrasound studies after endoscopic injection of dextranomer/hyaluronic acid copolymer for vesicoureteral reflux. Urology. 2006;68(4):866–8.CrossRefPubMed
45.
Puri P, Pirker M, Mohanan N, Dawrant M, Dass L, Colhoun E. Subureteral dextranomer/hyaluronic acid injection as first line treatment in the management of high 2 grade vesicoureteral reflux. J Urol. 2006;176(4 Pt 2):1856–9.CrossRefPubMed
46.
Pinto KJ, Pugach J, Saalfield J. Lack of usefulness of positioned instillation of contrast cystogram after injection of dextranomer/hyaluronic acid. J Urol. 2006;176(6 Pt 1):2654–6.CrossRefPubMed
47.
Perez-Brayfield M, Kirsch AJ, Hensle TW, Koyle MA, Furness P, Scherz HC. Endoscopic treatment with dextranomer/hyaluronic acid for complex cases of vesicoureteral reflux. J Urol. 2004;172:1614–6.CrossRefPubMed
48.
Läckgren G, Sköldenberg E, Stenberg A. Endoscopic treatment with stabilized nonanimal hyaluronic acid/dextranomer gel is effective in vesicoureteral reflux associated with bladder dysfunction. J Urol. 2007;177:1124–8.CrossRefPubMed
49.
Elmore JM, Scherz HC, Kirsch AJ. Dextranomer/hyaluronic acid for vesicoureteral reflux: success rates after initial treatment failure. J Urol. 2006;175(2):712–5.CrossRefPubMed
50.
Kitchens D, Minevich E, DeFoor W, Reddy P, Wacksman J, Sheldon C, et al. Endoscopic injection of dextranomer/hyaluronic acid copolymer to correct vesicoureteral reflux following failed ureteroneocystostomy. J Urol. 2006;176(4 Pt 2):1861–3.CrossRefPubMed
51.
Vemulakonda VM, Koyle MA, Lendvay TS, Risk MC, Kirsch AJ, Cheng EY, Cisek LJ, Campbell JB. Endoscopic treatment of symptomatic refluxing renal transplant ureteroneocystostomies in children 2010;14(2):212–5.
52.
Routh JC, Inman BA, Reinberg Y. Dextranomer/hyaluronic acid for pediatric vesicoureteral reflux: systematic review. Pediatrics. 2010;125:1010–9.CrossRefPubMed
53.
Molitierno JA Jr, Scherz HC, Kirsch AJ. Endoscopic injection of dextranomer hyaluronic acid copolymer for the treatment of vesicoureteral reflux in duplex ureters. J Pediatr Urol. 2008;4(5):372–6.CrossRefPubMed
54.
Cerwinka WH, Scherz HC, Kirsch AJ. Endoscopic treatment of vesicoureteral reflux associated with paraureteral diverticula in children. J Urol. 2007;178(4 Pt 1):1469–73.CrossRefPubMed
55.
Chertin B, Mohanan N, Farkas A, Puri P. Endoscopic treatment of vesicoureteral reflux associated with ureterocele. J Urol. 2007;178(4 Pt 2):1594–7.CrossRefPubMed
56.
Kaye JD, Srinivasan AK, Delaney C, Cerwinka WH, Elmore JM, Scherz HC, et al. Clinical and radiographic results of endoscopic injection for vesicoureteral reflux: Defining measures of success. J Pediatr Urol. 2012;8:297–303.CrossRefPubMed
57.
Kalisvaart JF, Scherz HC, Cuda S, Kaye JD, Kirsch AJ. Intermediate to long-term follow-up indicates low risk of recurrence after double HIT endoscopic treatment for primary vesicoureteral reflux. J Pediatr Urol. 2012;8:359–65.CrossRefPubMed
58.
De Badiola FI, Soria R, Vagni RL, Ormaechea MN, Moldes JM, Benmaor C. Results of Treatment of Grades IV and V Vesicoureteral Reflux with Endoscopic Injection of Polyacrylate Polyalcohol Copolymer. Front Pediatr. 2013;1:32.CrossRefPubMedPubMedCentral
59.
Corbetta JP, Bortagaray JI, Weller S, Ruiz J, Burek C, Sager C, et al. The use of polyacrylate-polyalcohol copolymer hydrogel in the endoscopic treatment of primary vesicoureteral reflux in children. J Pediatr Surg. 2015;50(3):485–8.CrossRefPubMed
60.
Garcia-Aparicio L, Rovira J, Blazquez-Gomez E, Garcia-Garcia L, Gimenez-Llort A, Rodo J, et al. Randomized clinical trial comparing endoscopic treatment with dextranomer hyaluronic acid copolymer and Cohen’s ureteral reimplantation for vesicoureteral reflux: long-term results. J Pediatr Urol. 2013;9:483–7.CrossRefPubMed
61.
•• Holmdahl G, Brandström P, Läckgren G, Sillén U, Stokland E, Jodal U, et al. The Swedish reflux trial in children: II. Vesicoureteral reflux outcome. J Urol. 2010;184:280–5. Multi-institutional, randomized, controlled trial demonstrating endoscopic treatment resulted in dilating reflux resolution or downgrading in most treated children. Recurrent dilating reflux was seen in 20% after 2years CrossRefPubMed
62.
Lee EK, Gatti JM, Demarco RT, Murphy JP. Long-term followup of dextranomer/hyaluronic acid injection for vesicoureteral reflux: late failure warrants continued followup. J Urol. 2009;181:1869–74.CrossRefPubMed
63.
Kraft KH, Molitierno JA Jr, Dewhurst L, Geers C, Gunderson K, Scherz HC, et al. Is endoscopic injection therapy a reasonable treatment option for low-grade vesicoureteral reflux in association with overactive bladder? Urology. 2011;78:675–8.CrossRefPubMed
64.
Chertin B, Abu Arafeh W, Kocherov S. Endoscopic correction of complex cases of vesicoureteral reflux utilizing Vantris as a new non-biodegradable tissue-augmenting substance. Pediatr Surg Int. 2014;30:445–8.CrossRefPubMed
65.
Van Batavia JP, Nees SN, Fast AM, Combs AJ, Glassberg KI. Outcomes of vesicoureteral reflux in children with non-neurogenic lower urinary tract dysfunction treated with dextranomer/hyaluronic acid copolymer (Deflux). J Pediatr Urol. 2014;10:482–7.CrossRefPubMed
66.
Pichler R, Buttazzoni A, Rehder P, Bartsch G, Steiner H, Oswald J. Endoscopic application of dextranomer/hyaluronic acid copolymer in the treatment of vesico-ureteric reflux after renal transplantation. BJU Int. 2011;107:1967–72.CrossRefPubMed
67.
Vemulakonda VM, Koyle MA, Lendvay TS, Risk MC, Kirsch AJ, Cheng EY, et al. Endoscopic treatment of symptomatic refluxing renal transplant ureteroneocystostomies in children. Pediatr Transplant. 2010;14:212–5.CrossRefPubMed
68.
Läckgren G, Wåhlin N, Sköldenberg E, Stenberg A. Long-term follow-up of children treated with dextranomer/hyaluronic acid copolymer for vesicoureteral reflux. J Urol. 2001;166:1887–92.CrossRefPubMed
69.
Oswald J, Riccabona M, Lusuardi L, Bartsch G, Radmayr C. Prospective comparison and 1-year follow-up of a single endoscopic subureteral polydimethylsiloxane versus dextranomer/hyaluronic acid copolymer injection for treatment of vesicoureteral reflux in children. Urology. 2002;60:894–7.CrossRefPubMed
70.
Hsieh MH, Madden-Fuentes RJ, Lindsay NE, Roth DR. Treatment of pediatric vesicoureteral reflux using endoscopic injection of hyaluronic acid/dextranomer gel: intermediate-term experience by a single surgeon. Urology. 2010;76:199–203.CrossRefPubMed
71.
Brandström P, Esbjörner E, Herthelius M, Swerkersson S, Jodal U, Hansson S. The Swedish reflux trial in children: III. Urinary tract infection pattern. J Urol. 2010;184:286–91.CrossRefPubMed
72.
Weiss R, Duckett J, Spitzer A. Results of a randomized clinical trial of medical versus surgical management of infants and children with grades III and IV primary vesicoureteral reflux (United States). J Urol. 1992;148:1667–73.CrossRefPubMed
73.
Cerwinka WH, Kaye JD, Leong TL, Elmore JM, Scherz HC, Kirsch AJ. Selective endoscopic treatment of the non-refluxing contralateral ureter prevents new contralateral vesicoureteral reflux. J Pediatr Urol. 2013;9:51–5.CrossRefPubMed
Metadaten
Titel
Endoscopic Treatment of Vesicoureteral Reflux
verfasst von
Angela M. Arlen
Andrew J. Kirsch
Publikationsdatum
03.07.2017
Verlag
Springer US
Erschienen in
Current Bladder Dysfunction Reports / Ausgabe 3/2017
Print ISSN: 1931-7212
Elektronische ISSN: 1931-7220
DOI
https://doi.org/10.1007/s11884-017-0431-6

Weitere Artikel der Ausgabe 3/2017

Current Bladder Dysfunction Reports 3/2017 Zur Ausgabe

Pediatric Bladder Dysfunction (S Hodges, Section Editor)

Oral Medications in the Treatment of Bladder Overactivity

Post-Prostatectomy and Acquired Voiding Dysfunction (V Tse, Section Editor)

Management of Patients with Concurrent Pelvic Organ Prolapse and Lower Urinary Tract Symptoms—Impact on Lower Urinary Tract Symptoms Following Prolapse Repair

Pediatric Bladder Dysfunction (SJ Hodges, Section Editor)

Reliability and Reproducibility of Pediatric Urodynamic Studies

Inflammatory/Infectious Bladder Disorders (MS Mourad, Section Editor)

Diagnosis and Treatments for Vesico-Enteric Fistulas: a 2017 Current Review

Post-Prostatectomy and Acquired Voiding Dysfunction (V Tse, Section Editor)

Preoperative Evaluation of Post-prostatectomy Urinary Incontinence: Examining the Evidence for Routine Use of Multichannel Urodynamics

Post-Prostatectomy and Acquired Voiding Dysfunction (V Tse, Section Editor)

Anti-incontinence Surgery in High-Risk Male Patients with Stress Urinary Incontinence—an Updated Review

Neu im Fachgebiet Urologie

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Varikozelen bei Jugendlichen: Das Für und Wider der Operation

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Prostatakarzinom: EU initiiert neues Screeningkonzept

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Blasenkarzinom – Biomarker statt Zytologie?
weitere anzeigen

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen