Endoscopic Treatment of Vesicoureteral Reflux with Collagen: Preliminary Report and Cost Analysis

Leonard, Michael P.; Decter, Allan; Mix, Lawrence W.; Johnson, Hjalmar W.; Coleman, Gerald U.

doi:10.1016/s0022-5347(01)66180-9

Cited by 29 publications

(9 citation statements)

References 19 publications

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“…Of these, seven studies did not discuss the safety or tolerability of the treatment [11,13,33,35,36,44,45,50]. Among those six studies that did report some information on safety findings, the following was noted.…”

Section: Safety Of Endoscopic Injection In Duplex Systemsmentioning

confidence: 99%

The clinical utility and safety of the endoscopic treatment of vesicoureteral reflux in patients with duplex ureters

Hensle

Reiley

Ritch

et al. 2010

Journal of Pediatric Urology

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Section: Safety Of Endoscopic Injection In Duplex Systemsmentioning

confidence: 99%

The clinical utility and safety of the endoscopic treatment of vesicoureteral reflux in patients with duplex ureters

Hensle

Reiley

Ritch

et al. 2010

Journal of Pediatric Urology

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“…The results of several studies suggest that Deflux is more cost effective than open surgery [29][30][31]. Kobelt et al used a mathematical model to suggest that medical costs decrease nearly 20% when open Deflux is used in place of ureteral reimplantation [29].…”

Section: Discussionmentioning

confidence: 99%

The demographics and costs of inpatient vesicoureteral reflux management in the USA

et al. 2011

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This study evaluates the impact of vesicoureteral reflux (VUR) on the economy and inpatient healthcare utilization in the USA. A retrospective analysis was performed on children ≤ 18 years of age, hospitalized with the principal discharge diagnosis of VUR between 2000 and 2006, using the Healthcare Cost and Utilization Project Kids' Inpatient Database. The results are stratified as follows. First, by hospitalizations: between 2000 and 2006, 6,655 ± 720 (standard error) children/year were hospitalized with VUR. Since 2003, both the length of each hospitalization and the number of hospitalizations have decreased. Second, by related procedures/diagnoses: ureteral reimplantation was the most common procedure, accounting for 89% of hospitalizations. Congenital genitourinary anomalies, disorders of the kidney/ureter/bladder, and urinary tract infections (UTI) were the most common related diagnoses. Thirdly, by hospital economics: since 2000, hospital charges for VUR increased despite decreased lengths of hospitalization. By 2006, hospital charges rose to $18,798/hospitalization, and aggregate national charges exceeded $100 million. Our results indicate that fewer children with VUR are requiring inpatient management. Children with VUR are often hospitalized for ureteral reimplantation or the management of related diagnoses. Since 2000, hospital charges for inpatient VUR management have increased. More efforts are needed to evaluate cost-effective strategies for the evaluation and management of VUR.

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“…With two decades of experience and thousands of patients treated, it remains an option when counselling patients and parents on the need for surgery, given the appropriate indications. The advantage of STING is that it is minimally invasive, may be accomplished as an outpatient procedure with minimal morbidity, and is more cost effective than open surgery (43,44). However, this must be balanced against the fact that STING has lower cure rates than open surgery; necessitates, in most cases, the injection of a foreign material, with potential for adverse reaction; and has limited data regarding long term cure rates.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic injection therapy for treatment of vesicoureteric reflux: A 20-year perspective

Leonard

2002

Paediatrics &Amp; Child Health

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OBJECTIVE:To review the application and outcome of endoscopic injection therapy for vesicoureteric reflux in regard to its evolution over the past two decades. DATA SOURCES: Review articles, original reports and abstracts pertaining to endoscopic injection therapy were obtained through a PubMed search of English, German and French publications from 1981 to 2001. DATA SELECTION: A total of 46 studies were selected. Four were selected to support basic concepts in the management of vesicoureteric reflux, and the remainder pertained specifically to endoscopic injection therapy for vesicoureteric reflux. DATA EXTRACTION: The reports were analyzed with focus on the physical properties of the biomaterial injected, results of treatment in regard to the cure of vesicoureteric reflux, duration of cure, and possible adverse effects and clinical benefits engendered by the use of injectable materials. DATA SYNTHESIS:Endoscopic injection therapy successfully cures vesicoureteric reflux in 60% to 80% of cases. Success rates are higher with particulate materials (Teflon and Macroplastique) than with bovine collagen or autologous chondrocytes. Long term data regarding cure are scant. Although concerns about particulate migration and autoimmune disease exist, these have not been borne out of clinical experience. Endoscopic injection may be accomplished on an outpatient basis, with less morbidity than with open ureteroneocystostomy. CONCLUSIONS: Endoscopic injection therapy should be offered as an alternative treatment in patients with indications to consider ureteroneocystotomy, but should not change the indications for surgical intervention. The ideal biomaterial for injection has yet to be developed, but the field of autologous tissue engineering holds promise for future development.

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Endoscopic Treatment of Vesicoureteral Reflux with Collagen: Preliminary Report and Cost Analysis

Abstract: Endoscopic injection of collagen is effective treatment for vesicoureteral reflux. Furthermore, it causes minimal morbidity and may effect cost savings in health care management.

Cited by 29 publications

References 19 publications

The clinical utility and safety of the endoscopic treatment of vesicoureteral reflux in patients with duplex ureters

The clinical utility and safety of the endoscopic treatment of vesicoureteral reflux in patients with duplex ureters

The demographics and costs of inpatient vesicoureteral reflux management in the USA

Endoscopic injection therapy for treatment of vesicoureteric reflux: A 20-year perspective

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