The comparison of dextranomer/hyaluronic acid and polyacrylate-polyalcohol copolymers in endoscopic treatment of vesicoureteral reflux

Karakuş, Süleyman Cüneyt; User, İdil Rana; Kılıç, Beltinge Demircioğlu; Akçaer, Vedat; Ceylan, Hasan Hüseyin; Özokutan, Bülent Hayrı

doi:10.1016/j.jpedsurg.2016.02.092

Cited by 22 publications

(16 citation statements)

References 22 publications

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“…A high level of reflux resolution using PPC is noted. The results showed that reflux was corrected in about 90% of cases after single PPC injection, with no recurrence during prospective follow-up [ 5 , 13 , 14 , 15 , 16 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, in 2016, were published 4 papers, which compared retrospectively the outcomes of endoscopic reflux correction using two bulking agents: dextranomer/hyaluronic acid copolymer versus polyacrylate-polyalcohol copolymer. The results revealed that success rate of PPC was significantly higher than that obtained with Dx/HA [ 16 , 17 , 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up

2017

CEJU

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IntroductionThe endoscopic correction of vesicoureteral reflux (VUR) in children is a currently well accepted therapy in many pediatric urology centers. Polyacrylate-polyalcohol copolymer (PPC), namely Vantris®, is one of the tissue-augmenting substances used for endoscopic reflux therapy. The aim of this study was to evaluate the results with PPC in children.Material and methodsFrom 2012 to 2016, 125 children (73 girls and 52 boys) aged 0.6–17.9 years (mean 4.9 ±3.58) were treated with PPC. VUR was unilateral in 64 and bilateral in 61 patients, comprising 197 renal refluxing units (RRUs) grades: II in 72, III in 50, IV in 33 and V in 42. Of these primary reflux was present in 132 RRUs and 65 were complex cases. Voiding cystourethrogram (VCUG) was done 3 months after procedure.ResultsFollow-up was completed in 89.6% of patients (112 children), and 89.8% of RRUs (177 out of 197). Reflux resolved in 86.4% of RRUs after single injection, in 99.4% after second and in 100% after the third. The only significant, but serious complication observed was late ureteral obstruction after PPC injection correcting high grade reflux, which required ureteral re-implantation. This complication was found in 9 out of 112 children (8%), and in 11 out of 177 RRUs (6.2%), 1.1 -2.9 years (mean 2 ±0.7) after the PPC injection. The longest follow-up reaches 4.5 years.ConclusionsOur data show that the PPC injection is an effective procedure for treating all grades of VUR with high success rate. However, because of the possibility of late ureteral obstruction, which requires ureteroneocystostomy, long-term follow-up is mandatory.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up

2017

CEJU

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“…Moreover, PPC and Dx/HA have been compared in many trials. [29][30][31] Endoscopic injection of PPC resulted in higher success rates. However, concerns have been raised with PPC regarding a high rate of ureteral obstruction.…”

Section: Bulking Agentsmentioning

confidence: 99%

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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“…The average diameter of particles is 320 nm which can reduce the risk of migration and nonbiodegradable nature leads to the formation of a fibrotic capsule that can result in better stability and long-term durability in treating VUR. Several studies reported successful short-term outcomes (88.6%–93.8% of resolution rate) with PPC, which are similar or even superior to Dx/HA [232425]. However, ureteral obstruction was more commonly seen in PPC group within several months or even years after injection [242526] and a recent animal study also revealed that PPC leaded severe fibrosis on injection site [27].…”

Section: Materials For Endoscopic Injectionmentioning

confidence: 99%

Endoscopic injection therapy

Kim

Lee

2017

Investig Clin Urol

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Since the U.S. Food and Drug Administration approved dextranomer/hyaluronic acid copolymer (Deflux) for the treatment of vesicoureteral reflux, endoscopic injection therapy using Deflux has become a popular alternative to open surgery and continuous antibiotic prophylaxis. Endoscopic correction with Deflux is minimally invasive, well tolerated, and provides cure rates approaching those of open surgery (i.e., approximately 80% in several studies). However, in recent years a less stringent approach to evaluating urinary tract infections (UTIs) and concerns about long-term efficacy and complications associated with endoscopic injection have limited the use of this therapy. In addition, there is little evidence supporting the efficacy of endoscopic injection therapy in preventing UTIs and vesicoureteral reflux-related renal scarring. In this report, we reviewed the current literature regarding endoscopic injection therapy and provided an updated overview of this topic.

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The comparison of dextranomer/hyaluronic acid and polyacrylate-polyalcohol copolymers in endoscopic treatment of vesicoureteral reflux

Cited by 22 publications

References 22 publications

Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up

Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up

Vesicoureteral reflux: From prophylaxis to surgery

Endoscopic injection therapy

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