Clinical Efficacy and Safety in Children with Vesicoureteral Reflux of a Single Injection of Two Different Bulking Agents – Polydimethylsiloxane (Macroplastique) or Dextranomer/Hyaluronic Acid Copolymer (Deflux): A Short-Term Prospective Comparative Study

Kim, Sun-Ouck; Shin, Bo Sung; Hwang, In Sang; Hwang, Eu Chang; Oh, Kyung Jin; Jung, Seung Il; Kang, Taek Won; Kwon, Dongdeuk; Park, Kwangsung; Ryu, Soo Bang

doi:10.1159/000324594

Cited by 9 publications

(6 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Today, Dx/HA is the most widely used substance -and the only approved by the Food and Drug Administration (FDA). However, although polydimethylsiloxane has not been approved in children yet, efficacy in the pediatric population has been widely acknowledged in the literature (15)(16)(17) . In our study, similarly to what Williams G et al reported in their 2019 meta-analysis (18) , healing rates were similar with both materials.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of intraoperative voiding cystourethrogram as an indicator of sucess in the endoscopic treatment of vesicoureteral reflux

et al. 2022

View full text Add to dashboard Cite

Objective. Up until now, serial voiding cystourethrogram (SVCU) has been regarded as the gold standard technique in the diagnosis of vesicoureteral reflux (VUR). The aim of intraoperative SVCU during endoscopic treatment is to detect those patients eligible to receive more biosynthetic material as a result of persistent VUR. The objective of this study was to assess the usefulness of SVCU as a predictor of treatment success.Materials and methods. An analytical, retrospective study of patient medical records was carried out. Patients included had undergone endoscopic VUR surgery from 2000 to 2019, and they were measured in ureteral units. VUR persistence at intraoperative SVCU following treatment was compared with SVCU results after 3 months.Results. Of a total of 167 ureteral units undergoing surgery, persistent reflux immediately after surgery was observed in 17 cases (10% of the sample). Only 3 cases had other urological malformations. In the SVCU carried out after 3 months, reflux was found in 38% of the sample (64 cases). When comparing the results, intraoperative SVCU demonstrated a specificity of 92.6%, and a sensitivity of 15.6%.Conclusions. Given the low sensitivity (15.6%) of intraoperative SVCU to detect cases of persistent reflux in the mid-term, and considering the risks associated with radiation in the pediatric population -which is extremely sensitive to it -, intraoperative SVCU should be ruled out as a useful indicator of endoscopic treatment success.

show abstract

Section: Discussionmentioning

confidence: 99%

Usefulness of intraoperative voiding cystourethrogram as an indicator of sucess in the endoscopic treatment of vesicoureteral reflux

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Our results are consistent with those reported by the authors who did not see a significant difference in cure rates when comparing Dx/HA and Macroplastique. [28][29][30] Even if no statistical difference was shown between both products, the price difference is an important consideration in choosing a bulking agent.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of dextranomer hyaluronic acid and polyacrylamide hydrogel in endoscopic treatment of vesicoureteral reflux: A comparative study

Blais

Morin

Cloutier

et al. 2015

CUAJ

View full text Add to dashboard Cite

Introduction: Various bulking agents are available for vesicoureteral reflux (VUR) endoscopic treatment, but their inconsistent success rates and costs are concerns for urologists. Recently, polyacrylamide hydrogel (PAHG) has been shown to have a good overall success rate, which seems comparable to dextranomer hyaluronic acid (Dx/HA), currently the most popular bulking agent. Our objective was to compare the short-term success rate of PAHG and Dx/ HA for VUR endoscopic treatment in children. Methods: We performed a prospective non-randomized study using PAHG and Dx/HA to treat VUR grades I to IV in pediatric patients. All patients underwent endoscopic sub-ureteric injection of PAHG or Dx/HA, using the double-HIT technique, followed by a 3-month postoperative renal ultrasound and voiding cystourethrogram. Treatment success was defined as the absence of de novo or worsening hydronephrosis and absence of VUR. Results: A total of 90 pediatric patients underwent an endoscopic injection: 45 patients (78 ureters) with PAHG and 45 patients (71 ureters) with Dx/HA. The mean injected volume of PAHG and Dx/ HA was 1.1 mL and 1.0 mL, respectively. The overall success rate 3 months after a single treatment was 73.1% for PAHG and 77.5% for Dx/HA. Postoperatively, 1 patient in each group presented with acute pyelonephritis and 2 patients in the Dx/HA group developed symptomatic ureteral obstruction. Conclusion: Success rates of PAGH and Dx/HA in endoscopic injections for VUR treatment were comparable. The rate of resolution obtained with Dx/HA was equivalent to those previously published. The lower cost of PAHG makes it an interesting option.

show abstract

“…Hoy en día la sustancia más utilizada, y la única aprobada por la Food and Drug Administration (FDA), es el Dx/HA. No obstante, a pesar de que el uso de polidimetilsiloxano no esté aprobado en niños, su eficacia en esta población está ampliamente recogida en la literatura (15)(16)(17) . En nuestro estudio, al igual que lo publicado por Williams y cols.…”

Section: Discussionunclassified

Utilidad de la cistouretrografía miccional intraoperatoria como indicador de éxito del tratamiento endoscópico del reflujo vesicoureteral

Costaya¹,

Farpón²,

Aparicio³

et al. 2022

Cir Pediatr

View full text Add to dashboard Cite

ResumenObjetivo. La cistouretrografía miccional seriada (CUMS) ha sido hasta ahora el gold standard en el diagnóstico del reflujo vesicoureteral (RVU). La finalidad de la CUMS intraoperatoria durante el tratamiento endoscópico es detectar aquellos pacientes subsidiarios de inyectar más material biosintético por persistencia del RVU. En este estudio hemos querido evaluar la utilidad de esta prueba como predictor de éxito del tratamiento.Material y métodos. Estudio analítico retrospectivo mediante la revisión de historias clínicas de pacientes, medidos en unidades ureterales, intervenidos de RVU de forma endoscópica entre los años 2000 y 2019. Se comparó la persistencia de RVU en la CUMS intraoperatoria tras el tratamiento con el resultado de la CUMS a los 3 meses.Resultados. De un total de 167 unidades ureterales intervenidas, se observó persistencia del reflujo inmediatamente tras la intervención en 17 casos (10% de la muestra). Solo 3 asociaban otras malformaciones urológicas. En la CUMS a los 3 meses se observó reflujo en el 38% de la muestra (64 casos). Al comparar los resultados, obtenemos para la CUMS intraoperatoria una especificidad del 92,6% y una sensibilidad del 15,6%.Conclusiones. Dada la baja sensibilidad (15,6%) de la CUMS intraoperatoria para detectar los casos en los que persiste el reflujo a medio plazo y, teniendo en cuenta los riesgos asociados a la radiación que supone en una población especialmente sensible como es la pediátrica, se desestima su utilidad como indicador de éxito del tratamiento endoscópico.Palabras Clave: Reflujo vesicoureteral; Cistouretrografía intraoperatoria; Tratamiento endoscópico; Copolímero de ácido hialurónico dextranómero; Polidimetilsiloxano. Usefulness of intraoperative voiding cystourethrogram as an indicator of success in the endoscopic treatment of vesicoureteral reflux AbstractObjective. Up until now, serial voiding cystourethrogram (SVCU) has been regarded as the gold standard technique in the diagnosis of vesicoureteral reflux (VUR). The aim of intraoperative SVCU during endoscopic treatment is to detect those patients eligible to receive more biosynthetic material as a result of persistent VUR. The objective of this study was to assess the usefulness of SVCU as a predictor of treatment success.Materials and methods. An analytical, retrospective study of patient medical records was carried out. Patients included had undergone endoscopic VUR surgery from 2000 to 2019, and they were measured in ureteral units. VUR persistence at intraoperative SVCU following treatment was compared with SVCU results after 3 months.Results. Of a total of 167 ureteral units undergoing surgery, persistent reflux immediately after surgery was observed in 17 cases (10% of the sample). Only 3 cases had other urological malformations. In the SVCU carried out after 3 months, reflux was found in 38% of the sample (64 cases). When comparing the results, intraoperative SVCU demonstrated a specificity of 92.6%, and a sensitivity of 15.6%.Conclusions. Given the low sensitivity (15.6%) of intr...

show abstract

Clinical Efficacy and Safety in Children with Vesicoureteral Reflux of a Single Injection of Two Different Bulking Agents – Polydimethylsiloxane (Macroplastique) or Dextranomer/Hyaluronic Acid Copolymer (Deflux): A Short-Term Prospective Comparative Study

Cited by 9 publications

References 51 publications

Usefulness of intraoperative voiding cystourethrogram as an indicator of sucess in the endoscopic treatment of vesicoureteral reflux

Usefulness of intraoperative voiding cystourethrogram as an indicator of sucess in the endoscopic treatment of vesicoureteral reflux

Efficacy of dextranomer hyaluronic acid and polyacrylamide hydrogel in endoscopic treatment of vesicoureteral reflux: A comparative study

Utilidad de la cistouretrografía miccional intraoperatoria como indicador de éxito del tratamiento endoscópico del reflujo vesicoureteral

Contact Info

Product

Resources

About