Single Center Experience with Endoscopic Subureteral Dextranomer/Hyaluronic Acid Injection as First Line Treatment in 1,551 Children with Intermediate and High Grade Vesicoureteral Reflux

Puri, Prem; Kutasy, Balázs; Colhoun, Eric; Hunziker, Manuela

doi:10.1016/j.juro.2012.02.023

Cited by 43 publications

(39 citation statements)

References 18 publications

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“…It has been a competitive alternative for open surgery, due to its acceptable success rate, safety and simplicity, less time consuming and short length of stay in hospital (12,20). Although the success rate for endoscopic interventions in VUR treatment varies between 70% and 90% in the literature, the optimal technique and bulking agent for STING are controversial (23,24). In addition, it is believed that the advantages of endoscopic intervention provide a possibility to repeat the procedure in case of failure or recurrence (25).…”

Section: Discussionmentioning

confidence: 99%

“…Although many studies suggest that appropriate selection of patients can lead to higher success rate, lower recurrence and complications, however biodegradable agents such as Dx/HA may cause VUR recurrence and failure during long-term follow up (25). The reported success rate is 70% for VUR correction using STING procedure in the literature (8,23). In the current study, the success rate for endoscopic correction of the VUR using Dx/HA injection was 93.3%, which provides a higher rate compared to the literature.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic correction of vesicoureteral reflux in children

Rahimi¹,

Nazarbaghi²,

Valizadeh³

et al. 2018

J Renal Inj Prev

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Implication for health policy/practice/research/medical education:Dextranomer/hyaluronic acid subureteric injection provides acceptable resolution rate among vesicoureteral reflux (VUR) patients and this highlights the necessity for the strict implementation of it in VUR. Additionally patients underwent a one-year follow up period, subsequently. Follow up included urine analysis, urine cultures and kidney and urinary tract ultrasonography study. Results: Of a total 30 patients, 8 patients (27%) were male and 22 patients (73%) were female. The mean age of patients was 25.19 ± 0.70 months. Postoperative VUR resolution was observed in 28 patients (93.3%). Moreover, during one year follow up, urinary tract infection (UTI) was not reported in patients. However, recurrent VUR was detected in 8 patients (27%) during ultrasonography follow up. Analysis showed no significant difference of recurrence in VUR between males and females (P = 0.285) and VUR severity (P = 0.1). There was a significant relationship between recurrent UTI history before intervention and VUR recurrence after subureteric injection (P = 0.007). Conclusion: Dx/HA acid subureteric injection provides acceptable resolution rate among VUR patients, but its biodegradability causes VUR recurrence during one-year follow up. Please cite this paper as:

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic correction of vesicoureteral reflux in children

Rahimi¹,

Nazarbaghi²,

Valizadeh³

et al. 2018

J Renal Inj Prev

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“…Over the last few decades, endoscopic subureteric injection with bulking agents has gained popularity in the treatment of VUR. Many authors have recommended endoscopic treatment (ET) as the first line of treatment (10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Efficiency of endoscopic treatment compared to open surgical management of the vesicoureteral reflux

Mugabe¹,

Kojović²

2018

Medicinski podmladak

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Introduction: Vesicoureteral reflux (VUR) represents the retrograde flow of urine from the bladder to the upper urinary tract. It can be managed by continuous antibiotic prophylaxis of the urinary tract infections until spontaneous resolution occurs, surgical ureteral reimplantation (ureteroneocystostomy), or endoscopic treatment by injecting bulking agents. The aim: To assess the efficacy of the endoscopic treatment of VUR in comparison to the ureteroneocystostomy. Material and methods: The first group included 300 children with VUR, II to IV grades managed by endoscopic injection from 2005 to 2015, and second group included 300 patients who underwent surgical treatment for the IV or V grade of VUR from 1997 until 2009. The results of treatment and complication rate were analysed and compared. We did the same analysis considering the total number of ureteral units. Results: Of total of 300 patients treated endoscopically, in 281 (93.67%) patients the reflux was completely resolved; in 10 (3.33%), the reflux was downgraded (decreased for one or two grades) and in 9 (3%) the intervention was unsuccessful. In 430 ureteral units, full resolution was achieved in 402 (93.49%) units; in 10 (2.33%), the reflux was downgraded and in 18 (4.65%) the reflux didn't resolve. In 300 patients who underwent open surgery, in 290 (96.7%) the reflux was resolved; in 8 (2.67%), the reflux was downgraded from the V/IV to the grades I to III; in 2 (0.66%) the operation was unsuccessful. Out of 480 ureteral units, in 463 (96.46%) units the reflux was resolved; in 13 (2.71%), the grade of reflux was reduced, while in 4 (0.83%) units the reflux was persistent. Recorded success rate didn't show any statistically significant difference between these two groups. The length of hospital stay was significantly shorter and the number of complications was lower in the group of patients treated by endoscopic injection. Conclusion: Comparable success rate, shorter hospital stay, and fewer complications make the endoscopic treatment more preferable option.

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“…However, its role in the management of high grade, i.e. grade IV and V reflux still is under debate [1,2,3,4]. A limited number of reports regarding results and efficacy of endoscopic management of high grade reflux is still available.…”

Section: Introductionmentioning

confidence: 99%

“…A limited number of reports regarding results and efficacy of endoscopic management of high grade reflux is still available. Various bulking agents were used for this purpose: polytetrafluoroethylene (PTFE) before 2000, dextranomer/hyaluronic acid copolymer (Dx/HA, Deflux ®) since 2000 and recently polyacrylate-polyalcoholcopolymer (PPC, Vantris ®) [4,5,6,7,8,9,10,11,12]. PPC (Vantris ®) a synthetic, non-absorbable tissueaugmenting substance was introduced into clinical practice in 2010 [13] and is currently used in some centers Around the world [14,15,16,17,18,19,20].The aim of the present study was to evaluate the efficacy of PPC injection to correct reflux grade IV and V in children.…”

Section: Introductionmentioning

confidence: 99%

The Results of Endoscopic Treatment of Grade IV and V Persistent Vesiocoureteral Reflux in Children Using PolyacrylatePolyalcohol Copolymer (Vantris)

Warchoł¹,

Krzemień²,

Szmigielska³

et al. 2017

ARC Journal of Urology

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Single Center Experience with Endoscopic Subureteral Dextranomer/Hyaluronic Acid Injection as First Line Treatment in 1,551 Children with Intermediate and High Grade Vesicoureteral Reflux

Abstract: Our results confirm the safety and efficacy of the endoscopic injection of dextranomer/hyaluronic acid in the eradication of high grade vesicoureteral reflux. We recommend this 15-minute outpatient procedure as the first line of treatment for high grade vesicoureteral reflux.

Cited by 43 publications

References 18 publications

Endoscopic correction of vesicoureteral reflux in children

Endoscopic correction of vesicoureteral reflux in children

Efficiency of endoscopic treatment compared to open surgical management of the vesicoureteral reflux

The Results of Endoscopic Treatment of Grade IV and V Persistent Vesiocoureteral Reflux in Children Using PolyacrylatePolyalcohol Copolymer (Vantris)

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