Vesicoureteral Reflux

Researchers are developing and managing the AnovaOS Network Powered Patient Registry to collect real-world patient data across various diseases globally. This registry aims to capture meaningful clinical information on diagnosis, infection course, treatments, and outcomes to enhance understanding and support future clinical trials and observational studies. The registry serves as a resource to better understand, prevent, diagnose, and treat diverse health conditions. Participants data will be gathered through this registry, which can also be used to recruit individuals for clinical trials and observational studies on promising therapies. The registry collects ongoing information on patients health status and treatments, enabling long-term monitoring and analysis. This observational study does not involve administering treatments but focuses on data collection and management. Participants will provide information through questionnaires or instruments, either personally or via an informed proxy, with an expected follow-up once per year. The research team will assess natural history, clinical effectiveness, safety, and quality of care over a period of five years. The registry includes patients with a wide range of conditions, and participation requires informed consent and the ability to complete follow-up data collection.

Researchers are investigating whether it is possible to perform kidney and bladder transplants together in patients who have chronic kidney disease caused by bladder problems or absence of a bladder. This early-phase, single-center study focuses on patients whose bladder issues have not improved with medical treatment and who need surgery to avoid long-term complications. The study includes patients with hostile bladders, defined by specific bladder pressure measurements or bladder muscle disorders, and candidates must be approved by a transplant team. Participants will receive a transplant of a cadaveric donor bladder either at the same time as or after their kidney transplant, instead of the usual method of using intestinal segments for bladder reconstruction. This is a single-group study where all patients receive this combined transplant procedure. The research aims to evaluate the feasibility of this approach and study the long-term function of the transplanted bladder. During the study, participants will be closely monitored for how well the transplanted organs work and for any serious side effects over the course of up to four years. The medical team will conduct evaluations including urinary function assessments and follow-up visits to understand the outcomes and safety of the combined transplant. The total study period includes careful long-term observation to assess the success and any risks associated with the procedure.

This research aims to evaluate the use of contrast-enhanced voiding ultrasonography CEVUS compared to direct isotope cystography for diagnosing vesicoureteral reflux VUR in children under 6 years old. The goal is to find an accurate diagnostic method that classifies the severity of VUR while minimizing harm from the testing procedures. The study recruits pediatric patients who have experienced at least two culture-positive urinary tract infections and excludes those with abnormal bladder function or posterior urethral valves. Participants undergo both direct isotope cystography and CEVUS on the same day, using standardized bladder filling volume and speed. These diagnostic tests are performed by a radiologist and an isotope specialist independently, each blinded to the others results. The study focuses on comparing the diagnostic accuracy of these two imaging techniques for identifying and grading VUR. During the study, researchers monitor the accuracy of CEVUS in detecting VUR within one day and observe any adverse effects related to CEVUS over a one-year period. Participants will receive both diagnostic procedures and their results will be compared. The study is conducted by Turku University Hospital and involves 100 children under six years old. Total involvement includes the diagnostic testing day and follow-up monitoring for safety outcomes.

This research aims to evaluate the safety and effectiveness of the drug Tamsulosin, a selective alpha-1 adrenergic blocker, in children diagnosed with Posterior Urethral Valve PUV after valve ablation. It focuses on understanding how Tamsulosin affects the upper urinary tract, bladder outlet resistance, intravesical detrusor pressure, and the recurrence of febrile urinary tract infections in this population. Participants will be divided into two groups. One group will receive maintenance therapy with anticholinergic medication Oxybutynin and continuous antibiotic prophylaxis Trimethoprimsulfamethoxazole. The other group will receive the same maintenance therapy plus Tamsulosin, dosed orally once daily at 0.1 mg for children under 2 years and 0.2 mg for children 2 years and older. Both groups will be monitored and compared over a one-year period. Throughout the study, children will undergo evaluations to monitor their upper and lower urinary tract health, including assessments of hydronephrosis improvement, vesicoureteric reflux resolution, renal function, bladder outlet resistance, and detrusor pressure. Researchers will also track the recurrence of febrile urinary tract infections and observe any side effects related to Tamsulosin. The study will last for one year with continuous safety monitoring to assess the drugs impact.

Researchers are studying how drugs given to children and young adults by their healthcare providers work in their bodies. The goal is to find the safest and most effective doses of these understudied drugs currently used as part of standard care. This observational study focuses on children up to 20 years old, including those who are SARS-CoV-2 positive, across various medical conditions. Participants are observed while receiving their prescribed drugs as part of their routine medical care. The study collects bodily fluid samples, such as whole blood and effluent samples, to measure how the drugs are processed in the body. Data collection lasts up to 90 days from consent, with an extended period of up to 210 days for participants with Down Syndrome at designated sites. During the study, participants will have samples taken to measure drug clearance, volume of distribution, elimination rate, half-life, absorption rate, area under the curve, maximum concentration, and time to maximum concentration. These measurements help researchers understand the pharmacokinetics and safety of the drugs. The study is sponsored by Duke University and participation may last several months depending on individual factors.

The trial investigates the impact of different antibiotic treatments on the digestive tract colonization by extended-spectrum beta-lactamase-producing Enterobacteriaceae E-ESBL in children with febrile urinary tract infections UTIs. E-ESBL bacteria are a significant public health concern due to their resistance to many antibiotics. This research compares the emergence of E-ESBL strains in stools following treatment with either intravenous amikacin or other recommended antibiotics like ceftriaxone or cefixime in young children. Participants receive treatment for febrile UTIs with either amikacin given intravenously or with usual antibiotics such as intravenous or intramuscular ceftriaxone or oral cefixime. Before starting antibiotics, an anorectal swab is taken to check for E-ESBL colonization. A follow-up swab is performed three to four days after starting treatment to assess changes in bacterial presence. Children are monitored for the presence and type of E-ESBL bacteria in their stools four days after treatment begins. Researchers also track antibiotic resistance patterns, fever resolution, side effects related to antibiotic use, and the rate of UTI relapse over one and a half months. Participation involves stool sampling and clinical evaluations during the treatment period, with the study expected to complete by mid-2026.

Urinary tract dilatation is a common congenital condition in children often detected earlier today due to advances in prenatal imaging. This research evaluates patients diagnosed with urinary tract dilatation either before or after birth, aiming to understand diagnostic approaches, progression, and long-term outcomes. The study also explores which dilatations require closer follow-up and additional testing, such as micturition cystourethrography and renal scintigraphy, and assesses the value of prenatal versus postnatal screening. The study retrospectively reviews records of pediatric patients diagnosed with urinary tract dilatation from prenatal or postnatal ultrasound between January 2000 and August 2021. It includes analysis of ultrasound measurements and follow-up imaging to identify significant abnormalities. The research focuses on monitoring the size, presence of hyperechogenicity, renal and bladder anomalies, and kidney diameters to better guide management and reduce unnecessary procedures. Participants will have their ultrasound data reviewed for size parameters, hyperechogenicity, and abnormalities at baseline and during follow-up periods. Researchers aim to correlate ultrasound findings with clinical outcomes to guide future monitoring strategies. The study involves analyzing multiple ultrasound reports over time to evaluate the progression and outcomes of urinary tract dilatation, helping inform better screening and treatment decisions for affected children.

Researchers are evaluating a new device called the Shuotong ureteroscopy for treating patients with upper urinary tract stones. This study compares the Shuotong ureteroscopy, which can crush and remove stones simultaneously, with conventional ureteroscopy. The goal is to improve the rate at which stones are completely removed from the body and reduce complications like stone fragments remaining or blocking the ureter again. The study has two groups patients treated with the Shuotong ureteroscopy device and those treated with conventional ureteroscopy methods. The Shuotong device allows surgeons to break and remove stones at the same time during a minimally invasive procedure through the natural urinary tract. This approach aims to be simpler, safer, and less traumatic, especially for larger stones in the upper urinary tract. Participants will undergo surgery and be monitored during the procedure for surgery time. One week after surgery, researchers will evaluate how effectively the stones were removed. Patients will be assessed for safety and stone removal success. The study started in 2020 and will continue until 2026. Participants between 18 and 85 years old with ureteral stones may take part in this trial.

Researchers are investigating whether adding spinal analgesia improves recovery for patients undergoing robotic-assisted laparoscopic upper urinary tract surgery under general anesthesia. This study aims to compare the effects of spinal analgesia with morphine and bupivacaine to an intravenous lidocaine infusion during surgery. It evaluates recovery using the Quality of Recovery 15 QoR-15 scale and examines pain, nausea, opioid use, time out-of-bed, length of hospital stay, and complications, along with monitoring potential side effects like hypotension and cardiac dysfunction. Participants are randomly assigned to receive either a single shot spinal analgesia before surgery with morphine and bupivacaine or an intravenous lidocaine infusion during surgery. The spinal analgesia involves a one-time injection before surgery, while the lidocaine is given continuously during the operation. A subgroup of patients will have advanced heart function measurements and blood samples taken before, during, and after surgery to analyze inflammation and cardiac issues. Throughout the study, recovery will be assessed through interviews using the QoR-15 scale before surgery, on the first day after surgery, and on the seventh day. Patients will also keep a diary recording pain levels at rest and during movement three times daily. Researchers will track many outcomes including pain, nausea, opioid use, time spent out of bed, length of stay, and complications up to 30 days after surgery. Safety monitoring includes heart and blood pressure measurements during surgery, and blood tests for inflammation and heart function after surgery.

Researchers are studying how long-term use of the antibiotic trimethoprim-sulfamethoxazole affects the gut microbiota diversity in children aged 1 to 3 years with vesicoureteral reflux grade 3 or higher. This study compares children receiving this antibiotic prophylaxis with two control groups children with uropathy not on antibiotic prophylaxis and healthy children without uropathy. The research aims to understand the relationship between antibiotic use, gut microbiota changes, and risks such as antibiotic resistance and immune system effects. Participants are divided into three groups children with grade 3 or higher vesicoureteral reflux on long-term trimethoprim-sulfamethoxazole treatment for at least five months, children with uropathy but not on long-term antibiotics, and healthy children without uropathy or antibiotic treatment. Stool samples are collected at home 24 hours before a hospital visit to analyze the gut microbiota. This observational study does not involve any drug administration or intervention beyond sample collection. During the study, parents collect stool samples from their children to assess the variety and composition of gut bacteria, including the presence of multi-resistant bacteria. Researchers will evaluate the gut microbiota diversity alpha- and beta-diversity and the number of bacterial genera at the start of the study. The study helps to monitor how long-term antibiotic use may disrupt gut bacteria and potentially influence health conditions related to immune function. Participation lasts through the sample collection and hospital visit, with no further treatment or follow-up required.