2023
Spontaneous vesicoureteral reflux resolution curves based on ureteral diameter ratio
Arlen A, Leong T, Kirsch A, Cooper C. Spontaneous vesicoureteral reflux resolution curves based on ureteral diameter ratio. Journal Of Pediatric Urology 2023, 19: 468.e1-468.e6. PMID: 37188603, DOI: 10.1016/j.jpurol.2023.04.028.Peer-Reviewed Original ResearchConceptsUreteral diameter ratioUrinary tract infectionPrimary vesicoureteral refluxVesicoureteral refluxSpontaneous resolutionRisk groupsBreakthrough febrile urinary tract infectionDistal ureteral diameter ratioFebrile urinary tract infectionLargest ureteral diameterObjective prognostic informationGrade of refluxHigh-risk patientsLow-risk patientsHigh-risk groupLow-risk groupLow-risk childrenVUR resolutionPrimary refluxProphylactic antibioticsVUR gradeConservative managementPersistent refluxRisk patientsTract infections
2020
Endoscopic Treatment of Vesicoureteral Reflux
Arlen A, Kirsch A. Endoscopic Treatment of Vesicoureteral Reflux. 2020, 243-249. DOI: 10.1007/978-3-030-57219-8_17.Peer-Reviewed Original ResearchVesicoureteral refluxUreteral reimplantationContinuous low-dose antibiotic prophylaxisLow-dose antibiotic prophylaxisDextranomer hyaluronic acidPrimary vesicoureteral refluxDouble hydrodistention implantation techniqueInjectable bulking agentHydrodistention implantation techniqueSubureteric injectionUreteral hydrodistentionAntibiotic prophylaxisTeflon pasteEndoscopic correctionEndoscopic treatmentPatient morbidityRecurrence rateOnly FDASubmucosal planeReimplantationImplantation techniqueAmbulatory natureRefluxImproved successHyaluronic acid
2018
Impact of continuous low-dose antibiotic prophylaxis on growth in children with vesicoureteral reflux
Guidos P, Arlen A, Leong T, Bonnett M, Cooper C. Impact of continuous low-dose antibiotic prophylaxis on growth in children with vesicoureteral reflux. Journal Of Pediatric Urology 2018, 14: 325.e1-325.e7. PMID: 30181099, DOI: 10.1016/j.jpurol.2018.07.007.Peer-Reviewed Original ResearchConceptsContinuous antibiotic prophylaxisBody mass indexPrior treatment coursesPrior antibiotic useAntibiotic prophylaxisVesicoureteral refluxBMI percentileYears of ageTreatment courseMass indexAntibiotic useHeight percentilesContinuous low-dose antibiotic prophylaxisUse of CAPLow-dose antibiotic prophylaxisPrior antibiotic usageSignificant BMI increaseMainstay of treatmentUrinary tract infectionPrimary vesicoureteral refluxSignificant increaseUse of antibioticsBreakthrough infectionsEffects of antibioticsTract infections
2017
Endoscopic Treatment of Vesicoureteral Reflux
Arlen A, Kirsch A. Endoscopic Treatment of Vesicoureteral Reflux. Current Bladder Dysfunction Reports 2017, 12: 217-224. DOI: 10.1007/s11884-017-0431-6.Peer-Reviewed Original ResearchPrimary vesicoureteral refluxVesicoureteral refluxRenal scarringClinical courseRecurrent febrile urinary tract infectionsFebrile urinary tract infectionLaparoscopic/robotic approachChild's clinical courseContinuous antibiotic prophylaxisUltimate success rateUrinary tract infectionMajority of childrenInvasive surgical proceduresAntibiotic prophylaxisEfficacy rateEndoscopic injectionPersistent refluxReflux gradeTract infectionsEndoscopic correctionEndoscopic treatmentSurgical repairRecurrent infectionsSurgical interventionSurgical correctionValidation of the ureteral diameter ratio for predicting early spontaneous resolution of primary vesicoureteral reflux
Arlen AM, Kirsch AJ, Leong T, Cooper CS. Validation of the ureteral diameter ratio for predicting early spontaneous resolution of primary vesicoureteral reflux. Journal Of Pediatric Urology 2017, 13: 383.e1-383.e6. PMID: 28256423, DOI: 10.1016/j.jpurol.2017.01.012.Peer-Reviewed Original ResearchConceptsPrimary vesicoureteral refluxUreteral diameter ratioVesicoureteral refluxReflux gradeSpontaneous resolutionVUR gradeMultivariable modelUreteral diameterDistal ureteral diameter ratioGrade of VURLargest ureteral diameterPersistent vesicoureteral refluxVesicoureteral reflux gradeGrade of refluxImportant prognostic factorSpontaneous resolution rateValuable prognostic informationL3 vertebral bodyUnit increaseExternal validation studyHighest likelihood ratioVUR timingPersistent diseasePrimary outcomePrognostic factors
2016
Vesicoureteral Reflux Index: Predicting Primary Vesicoureteral Reflux Resolution in Children Diagnosed after Age 24 Months
Garcia-Roig M, Ridley DE, McCracken C, Arlen AM, Cooper CS, Kirsch AJ. Vesicoureteral Reflux Index: Predicting Primary Vesicoureteral Reflux Resolution in Children Diagnosed after Age 24 Months. Journal Of Urology 2016, 197: 1150-1157. PMID: 27939835, DOI: 10.1016/j.juro.2016.12.008.Peer-Reviewed Original ResearchConceptsResolution/improvementAge 24 monthsReflux indexIndex scoreReflux gradeUreteral abnormalitiesImprovement/resolutionVesicoureteral reflux gradeGrade of improvementHigh grade refluxPrimary vesicoureteral refluxMedian resolution timesProportional subdistribution hazards modelSubdistribution hazard modelVesicoureteral reflux resolutionGrade refluxDifferent time pointsSD ageLatest followupVesicoureteral refluxReflux resolutionVoiding cystourethrogramFemale genderInclusion criteriaDiagnosis increasesInter-rater reliability of distal ureteral diameter ratio compared to grade of VUR
Swanton A, Arlen A, Alexander S, Kieran K, Storm D, Cooper C. Inter-rater reliability of distal ureteral diameter ratio compared to grade of VUR. Journal Of Pediatric Urology 2016, 13: 207.e1-207.e5. PMID: 28089295, DOI: 10.1016/j.jpurol.2016.10.021.Peer-Reviewed Original ResearchConceptsUreteral diameter ratioDistal ureteral diameter ratioVesicoureteral refluxVUR gradeInter-rater reliabilityReflux gradePediatric urologistsGrade of VURGrading of VURLargest ureteral diameterHigh grade refluxImportant prognostic factorPrimary vesicoureteral refluxConfidence intervalsSignificant inter-rater variabilityGood inter-rater reliabilityPrognostic factorsClinical courseClinical outcomesPredictive factorsRenal unitsUreteral diameterInter-rater agreementSpontaneous resolutionBlinded fashionDelayed upper tract drainage on voiding cystourethrogram may not be associated with increased risk of urinary tract infection in children with vesicoureteral reflux
Garcia-Roig M, Arlen AM, Huang JH, Filimon E, Leong T, Kirsch AJ. Delayed upper tract drainage on voiding cystourethrogram may not be associated with increased risk of urinary tract infection in children with vesicoureteral reflux. Journal Of Pediatric Urology 2016, 12: 312.e1-312.e6. PMID: 27492248, DOI: 10.1016/j.jpurol.2016.04.056.Peer-Reviewed Original ResearchConceptsUpper tract drainageCulture-proven UTIsVesicoureteral refluxUTI ratesVUR gradeUTI riskRisk factorsHigh inter-observer correlationSetting of obstructionUTI risk factorsUrinary tract infectionPrimary vesicoureteral refluxPredictors of infectionAvailable prognostic informationSignificant predictorsYears of ageEndoscopic VUR treatmentHydrodistention gradeInter-observer agreementRecurrent UTIUTI incidenceVUR timingEndoscopic findingsInter-observer correlationTract infectionsComputer model predicting breakthrough febrile urinary tract infection in children with primary vesicoureteral reflux
Arlen AM, Alexander SE, Wald M, Cooper CS. Computer model predicting breakthrough febrile urinary tract infection in children with primary vesicoureteral reflux. Journal Of Pediatric Urology 2016, 12: 288.e1-288.e5. PMID: 27072485, DOI: 10.1016/j.jpurol.2016.03.005.Peer-Reviewed Original ResearchConceptsBreakthrough febrile urinary tract infectionFebrile urinary tract infectionPrimary vesicoureteral refluxBladder-bowel dysfunctionOnset of VURUrinary tract infectionVesicoureteral refluxLow bladder volumesBladder volumeUTI historyTract infectionsPrognostic calculatorSpontaneous resolutionRecurrent febrile urinary tract infectionsCorrect vesicoureteral refluxRecurrent febrile infectionsRenal parenchymal scarringIndividual child's riskCharacteristic curve areaParenchymal scarringVCUG findingsRenal scarringPatient demographicsVUR gradeFebrile infections