Long-term results of endoscopic treatment of vesicoureteral reflux in children: Comparison of different bulking agents

Stredele, Regina; Dietz, Hans–Georg; Stehr, Maximilian

doi:10.1016/j.jpurol.2011.12.004

Cited by 33 publications

(25 citation statements)

References 36 publications

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“…14,15 The variable degree of ingrowth of native fibroblasts, the shrinkage of the bulking agent, and the reported immunological reactions after injection of collagen are reasons why cross-linked bovine collagen has been abandoned by most centres.…”

Section: Bulking Agentsmentioning

confidence: 99%

“…24 A systematic review has shown an overall success rate per ureter of 77% at three months, while a German study noted a success rate of 81.5% at three months. 25,26 Many groups have compared the results obtained with a single injection of PDMS vs. Dx/HA copolymer for VUR endoscopic treatment. The results are variable, ranging from no difference to a better success rate with PDMS.…”

Section: Bulking Agentsmentioning

confidence: 99%

See 1 more Smart Citation

Vesicoureteral reflux: From prophylaxis to surgery

Blais¹,

Bolduc²,

Moore³

2017

CUAJ

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Vesicoureteral reflux (VUR) is one of the most common pathologies encountered in pediatric urology. Better understanding of the evolution of VUR and new endoscopic surgical techniques in the last decades have led to major changes in the management of this pathology. However, the treatment algorithm remains complex and is composed of a wide variety of options, from active surveillance to surgical treatment. Herein, we propose to review treatment options for VUR in order to help clinicians make the right treatment decision for the right patient.

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Section: Bulking Agentsmentioning

confidence: 99%

Section: Bulking Agentsmentioning

confidence: 99%

Vesicoureteral reflux: From prophylaxis to surgery

Blais¹,

Bolduc²,

Moore³

2017

CUAJ

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“…It is the most studied material, offering good success rates, with available long-term data of at least 3 years. 5,6 However, Dx/HA is not the perfect bulking agent; its success rate varies widely, 7 as it has a significant recurrence rate and shows 25% shrinkage in the following weeks following the injection. 8 Moreover, Dx/HA is expensive and the cost of endoscopic treatment has increased over the years mainly because of the increase in the amount of product needed to be injected.…”

Section: Introductionmentioning

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

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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.

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“…DISKUSIJA REZULTATA Obrađeni su podaci 50 pacijenata (ukupno 79 ureteralnih jedinica), lečeni u Univerzitetskoj dečjoj klinici. Distribucija prema polovima u ovoj studiji je 24% dečaka i 76% devojčica, što je očekivano i približno se poklapa sa polnom distribucijom iz durgih studija [10,11]. Starosna struktura pacijenata je od 18 meseci do 11 godina, dok su se u drugim studijama prikazivali rezultati na znatno širem starosnom opsegu od uzrasta od nepunih mesec dana pa do preko 15 godina (10, 11, 2).…”

Section: Rezultatiunclassified

“…adolescentima kod kojih konzervativni tretman nema uspeha (1). I u drugim studijama nije bilo dece sa prvim gradusom refluksa koji su uključeni u studiju (12,13,11), dok je najviše bio zastupljen gradus III (13). Gradus V u našoj studiji bio je zastupljen sa 10.2%, manje nego u stidiji Chertina i saradnika [13], dok pojedini autori nisu uzimali u obzir gradus V [11].…”

Section: Rezultatiunclassified

Advantages and disadvantages of various bulking agents in endoscopic treatment of vesicoureteral reflux

Juloski¹,

Stojanovic²,

Kovačević³

et al. 2014

Tehnika

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Long-term results of endoscopic treatment of vesicoureteral reflux in children: Comparison of different bulking agents

Abstract: Clinically and radiologically, Dx/HA exhibited the best results, giving better protection against UTIs and a better VUR cure rate. There was still a risk of VUR recurrence in successfully treated children after 3 years of follow up.

Cited by 33 publications

References 36 publications

Vesicoureteral reflux: From prophylaxis to surgery

Vesicoureteral reflux: From prophylaxis to surgery

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

Advantages and disadvantages of various bulking agents in endoscopic treatment of vesicoureteral reflux

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