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 other's 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 (Trimethoprim/sulfamethoxazole). 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 drug's impact.

This research aims to study whether oral antibiotic treatment alone is possible and safe for clinically stable children aged between 4 weeks and 2 months who have a suspected or confirmed urinary tract infection and no past high-risk medical history. The study is observational and focuses on uncomplicated urinary tract infections in this young population to evaluate treatment feasibility and safety. Clinically stable children without high-risk medical history will start oral antibiotic therapy using amoxicillin-clavulanic acid given in three doses totaling 50 mg/kg/day. If urine culture sensitivity results are available, a narrower spectrum antibiotic may be used instead. If a child becomes unstable or has a confirmed positive blood culture, treatment will change to parenteral antibiotics such as gentamicin and ampicillin. Children admitted to hospital will be sent home after clinical improvement, typically after at least one day. Participants will undergo a follow-up visit or virtual check approximately 72 hours after starting treatment to monitor improvement and adherence. Antibiotic therapy will last 10 days, during which children will have a renal ultrasound. Researchers will track outcomes including recurrence of urinary tract infection or death within 28 and 100 days after treatment, days admitted for urinary symptoms, and antibiotic-related side effects. The total study period includes treatment and follow-up assessments to monitor safety and treatment success.

Researchers are investigating how certain drugs prescribed to children and young adults act within their bodies. The goal is to find the safest and most effective doses for these understudied drugs given as part of standard medical care. This observational study focuses on pharmacokinetics (PK), including how drugs are absorbed, distributed, metabolized, and eliminated, with special attention to participants with conditions such as COVID-19 and Down Syndrome. Participants include children and young adults under 21 years who are either prescribed drugs of interest by their healthcare providers or have tested positive for SARS-CoV-2 within 60 days before enrollment. The study collects bodily fluid samples, like whole blood and effluent samples, to analyze drug behavior. Data collection lasts up to 90 days from consent, extended to 210 days for participants with Down Syndrome at designated sites. During the study, participants undergo PK sampling to measure various drug-related factors such as clearance, volume of distribution, elimination rate, half-life, absorption rate, maximum concentration, and time to reach maximum concentration. Researchers gather data at intervals up to 90 or 210 days, depending on participant status. The study monitors safety and drug effects without altering prescribed treatments, aiming to better understand drug profiles in pediatric and young adult populations.

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.