Vesico-ureteric reflux in adults with neuropathic bladders treated with Polydimethylsiloxane (Macroplastique®)

Shah, Nimisha; Kabir, Md. Jahangir; Lane, T. J. D.; Avenell, S; Shah, P.J.R.

doi:10.1038/sj.sc.3101090

Cited by 11 publications

(16 citation statements)

References 24 publications

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“…reported complete resolution of VUR after ESI in five (63%) of eight adults with neuropathic bladder caused by spinal cord injury. Shah et al 10 . reported the outcomes of ESI for 22 ureter units with neuropathic bladder.…”

Section: Discussionmentioning

confidence: 99%

“…VUR resolved in 72.2% (16 ureters) following a single injection. The authors suggested that ESI could be used as the first‐line treatment for VUR in adults with neurogenic bladder 10 . Diverse pathological conditions may cause neurogenic bladder dysfunction, and the physiological and functional changes may vary.…”

Section: Discussionmentioning

confidence: 99%

“…Foley et al 9 reported complete resolution of VUR after ESI in five (63%) of eight adults with neuropathic bladder caused by spinal cord injury. Shah et al 10 reported the outcomes of ESI for 22 ureter units with neuropathic bladder. Of the fifteen patients, 12 had neurogenic detrusor overactivity, two had detrusor areflexia and one had loss of bladder wall compliance.…”

Section: Discussionmentioning

confidence: 99%

“…The authors suggested that ESI could be used as the first-line treatment for VUR in adults with neurogenic bladder. 10 Diverse pathological conditions may cause neurogenic bladder dysfunction, and the physiological and functional changes may vary. Hence the favorable results reported for ESI in VUR with neurogenic bladder do not lead to a clear conclusion.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of endoscopic subureteral injection for vesicoureteral reflux in adults with decreased bladder compliance

Lee¹,

Han²,

Jeong³

et al. 2010

Int J of Urology

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Objective: To evaluate the outcome of endoscopic subureteral injection (ESI) in adults with vesicoureteral reflux (VUR) associated with decreased bladder compliance (D-BC). Methods: We retrospectively reviewed the medical records of 46 consecutive patients who underwent ESI for VUR at a single tertiary academic center. Fourteen patients (17 ureter units) who had underlying neurological disease with decreased bladder compliance, as determined by filling cystometry, were grouped as D-BC. Thirty-two patients (47 units) who had no signs or symptoms that suggested neurogenic lower urinary tract dysfunctions were grouped as normal bladder compliance (N-BC). We compared the cure rates for ESI between groups, defining cure as complete resolution of reflux on voiding cystourethrogram. Results: In 70.6% of the D-BC group and 70.2% of the N-BC group, VUR resolved completely after the first injection (P = 0.977). One failed unit of D-BC was cured after second ESI, and seven failed units of N-BC were cured after additional treatments (second ESI, two patients; ureteroneocystostomy, five patients). No additional treatments were applied to three units of D-BC or seven units of N-BC without symptoms. No complications related to the ESI were observed. Conclusions: The ESI was found to be effective in adults with VUR regardless of the bladder compliance. As a minimally invasive procedure with a favorable outcome, ESI may represent the first choice for treatment of VUR even in adults with D-BC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Efficacy of endoscopic subureteral injection for vesicoureteral reflux in adults with decreased bladder compliance

Lee¹,

Han²,

Jeong³

et al. 2010

Int J of Urology

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show abstract

“…Macroplastique with dosage variable (0.7-1.5 ml) was injected submucosally under each ureteric orifice to convert the opening to a slit-like shape. 11,12 One-month post-treatment, new videourodynamics showed that all VUR had disappeared. Only one patient with SS-SCL was retreated with Macroplastique for recurrence of monolateral VUR (grade II) 1-year after the first treatment.…”

Section: Detrusor Acontractility or Underactivitymentioning

confidence: 99%

A retrospective study on female urological surgeries over the 10 years following spinal cord lesion

et al. 2013

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Objectives: To evaluate the efficacy and safety over a 10-year period of any urological operations required by female patients with spinal cord lesions (SCLs). Methods: Retrospective study of urological surgeries from our database performed on females with SCLs from 2001 to 2002. Surgery efficacy for neurogenic lower urinary tract dysfunctions (N-LUTDs) was evaluated by comparing 7-day voiding diaries pre-and post-surgeries, while individual investigations were done pre-and post-surgery to evaluate urological complications. Drawbacks were assessed. Results: Thirty-eight out of 69 patients underwent one or more urological procedures. Twenty-one out of 42 patients with suprasacral lesions underwent interventions for N-LUTD. The main surgical treatment was endoscopic detrusor infiltration of botulinum-A (Botox 300 UI or Dysport 750 UI) performed 107 times on 15 subjects using aseptic intermittent catheterizations for neurogenic overactive bladder. Mean efficacy duration was 9.2 months. Six females with infrasacral lesions underwent at least one intervention for N-LUTD. Two females in each group underwent tension-free vaginal tape for stress urinary incontinence (SUI), reducing episodes per week of SUI by 490% after 5 years. The most serious urological complication was active vesico-ureteral reflux (VUR) in three patients, treated endoscopically with submucosal injection of Macroplastique. No VUR recurrence was detected during a 6-year follow-up. All bladder stones (five cases) and renal calculi (five cases) were treated with endoscopic transurethrally electrohydraulic lithotripsy and extracorporeal shock-wave lithotripsy, respectively. Overall, no serious drawbacks were observed. Conclusions: Mini-invasive surgeries were exclusively used to address urological issues in chronic SCL patients.

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Injectable biomaterials for incontinence and vesico‐ureteral reflux: Current status and future promise

2005

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Many injectable biomaterials have been produced as bulking agents for compression of urethral sphincter or ureteral orifice for treating adult stress incontinence or vesico-ureteral reflux in pediatrics. The agents being developed include glutaraldehyde crosslinked collagen, dextranomer/hyaluronic acid copolymer, pyrolytic carbon-coated zirconium oxide beads, polydimethyl-siloxane microparticles, polytetrafluoroethylene paste, autologous fats, autologous chondrocytes, and others. Though less invasive nature of these agents has gained their popularity as a quick solution of the disease symptoms, most of such treatments fail to produce good long-term efficacy. The failure is likely caused by the rapid degradation of material implants and the lack of tissue regeneration/integration properties. We thus believe that a good injectable biomaterial for incontinence should possess the following two properties: (1) to resist degradation and to reside in the implantation sites for a long period of time or (2) to enhance tissue regeneration and to establish permanent periurethral or subureteric tissue. Here we report some recent results for supporting this hypothesis.

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Vesico-ureteric reflux in adults with neuropathic bladders treated with Polydimethylsiloxane (Macroplastique®)

Cited by 11 publications

References 24 publications

Efficacy of endoscopic subureteral injection for vesicoureteral reflux in adults with decreased bladder compliance

Efficacy of endoscopic subureteral injection for vesicoureteral reflux in adults with decreased bladder compliance

A retrospective study on female urological surgeries over the 10 years following spinal cord lesion

Injectable biomaterials for incontinence and vesico‐ureteral reflux: Current status and future promise

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