Influence of Voiding Dysfunction on the Outcome of Endoscopic Treatment for Vesicoureteral Reflux

Capozza, Nicola; Lais, Alberto; Matarazzo, Ennio; Nappo, Simona Gerocarni; Patricolo, Mario; Caione, Paolo

doi:10.1097/00005392-200210020-00009

Cited by 18 publications

(12 citation statements)

References 19 publications

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“…Similarly, about half the present failures had mound displacement after the first injection of PMS (Table 1). Similarly, others [8,6] reported displacement of the mound in failed cases after collagen injection, and after DHA in most failures (60%) [5], as in the present series with DHA. Therefore, we conclude that the proper injection site and the persistence of the injected material in this site are the most important factors for a successful endoscopic injection.…”

Section: Discussionsupporting

confidence: 87%

“…There are many reports of series focused on the success rate as related to reflux severity and number of procedures and/or the type of injectable material. Recently, anatomical causes of failure were analysed [2] but only a few studies have addressed the mechanism of failure after endoscopic injection and its relationship with the type of injected material or the location of the ureteric orifice [3][4][5][6][7][8][9][10]. A recent study by Diamond et al [2] noted the anatomical reasons for failure with alginated chondrocyte injection therapy.…”

Section: Introductionmentioning

confidence: 99%

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The effect of location of the ureteric orifice on the efficacy of endoscopic injection to correct vesico‐ureteric reflux

Yücel¹,

Uçar²,

Günteki̇n³

et al. 2005

BJU International

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excluded from the analysis; in all, 52 ureters were analysed. According to the international classification, the VUR was grades I to V in four (8%), 12 (23%), 16 (31%), 13 (25%) and seven (13%) ureters, respectively. RESULTSAfter 3 months, voiding cysto-urethrography showed that VUR continued in six of 19, seven of 12 and eight of 21 ureters (38%), respectively, after subureteric PTFE, polydimethylsiloxane and dextranomer/ hyaluronic acid copolymer injection; after the second injection, reflux continued in two of six, four of seven and three of eight ureters, respectively. Mound displacement and/or volume loss was the most common failure with all three bulking agents after both the first (62%) and second injections (44%) ( P < 0.05). The first injection failed in 32% (11 of 35) normally located ureters and 10 of 17 lateral ureters ( P < 0.05). The second injection failed in 11% (four of 35) normal and five of 17 lateral ureters ( P < 0.05). CONCLUSIONSA lateral ureteric orifice may decrease the efficacy of endoscopic injection, as the likelihood of a faulty injection is greater. However, a more careful second injection decreases the failure rate, particularly in those with low-to medium-grade refluxing ureters.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

The effect of location of the ureteric orifice on the efficacy of endoscopic injection to correct vesico‐ureteric reflux

Yücel¹,

Uçar²,

Günteki̇n³

et al. 2005

BJU International

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“…In general, cure rates for complex cases of VUR are lower than for primary VUR. Treatment of VUR associated with neurogenic bladder was shown to yield acceptable outcome whereas voiding dysfunction was a significant predictor of treatment failure [13, 25]. Endoscopic injection has been successfully employed in patients who either failed ureteral reimplantation or initial injection [13, 14, 26].…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Treatment of Vesicoureteral Reflux with Dextranomer/Hyaluronic Acid in Children

Cerwinka

Scherz

Kirsch

2008

Advances in Urology

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Purpose. The goal of this review is to present current indications, injectable agents, techniques, success rates, complications, and potential future applications of endoscopic treatment for vesicoureteral reflux (VUR) in children. Materials and Methods. The endoscopic method currently achieving one of the highest success rates is the double hydrodistention-implantation technique (HIT). This method employs dextranomer/hyaluronic acid copolymer, which has been used in pediatric urology for over 10 years and may be at present the first choice injectable agent due to its safety and efficacy. Results. While most contemporary series report cure rates of greater than 85% for primary VUR, success rates of complicated cases of VUR may be, depending on the case, significantly lower. Endoscopic treatment offers major advantages to patients while avoiding potentially complicated open surgery. As the HIT method continues to be applied to complex cases of VUR and more outcome data become available, the indication for endoscopic treatment may exceed the scope of primary VUR. Conclusions. Endoscopic injection is emerging as the treatment of choice for VUR in children.

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“…The good outcome in children with bladder dysfunction can probably be attributed to the treatment of this condition before and after surgery, as arranged with the paediatric nephrologist. Uncontrolled voiding dysfunction, may affect the success rate of both ureteric reimplantation [26,27] and endoscopic treatment [28].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic treatment with polydimethylsiloxane in children with dilating vesico‐ureteric reflux

et al. 2006

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OBJECTIVETo report our experience of treating dilating vesico-ureteric reflux (VUR) in children, using an injectable form of polydimethylsiloxane (Macroplastique TM , MPQ; Uroplasty BV, Geleen, The Netherlands), as medical treatment for moderate or severe VUR is associated with a high proportion of persistence or development of new scars. PATIENTS AND METHODSThe study included 32 children (40 ureters) with VUR; 13 (32%) were grade III, 20 (50%) grade IV and seven (18%) grade V. They were treated over a period of 42 months, 66% for some form of bladder dysfunction and 38% had associated diseases. The main indications were VUR grade, recurrent urinary tract infection and progression of reflux nephropathy. MPQ was injected under general anaesthesia via an 11 F cystoscope, × 30 objective, with a 5 F working channel. RESULTSThe mean ( SD ) follow-up was 28.5 (10.2) months; VUR resolved in 80% of patients and improved to minimal VUR in the remaining 20%. The resolution/ improvement rate was 72% after the first injection, 97% after the second and 100% after the third. There were no significant complications. CONCLUSIONThe endoscopic implantation of MPQ always corrected VUR even though 68% of the cases were grade IV-V. It should become the treatment of choice for severe VUR.

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Influence of Voiding Dysfunction on the Outcome of Endoscopic Treatment for Vesicoureteral Reflux

Cited by 18 publications

References 19 publications

The effect of location of the ureteric orifice on the efficacy of endoscopic injection to correct vesico‐ureteric reflux

The effect of location of the ureteric orifice on the efficacy of endoscopic injection to correct vesico‐ureteric reflux

Endoscopic Treatment of Vesicoureteral Reflux with Dextranomer/Hyaluronic Acid in Children

Endoscopic treatment with polydimethylsiloxane in children with dilating vesico‐ureteric reflux

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