Endoscopic Injection for the Correction of Vesicoureteral Reflux
DOI:
https://doi.org/10.51481/amc.v58i4.940Keywords:
vesicoureteral reflux, endoscopic treatmentAbstract
Introduction: Endoscopic suburetal injection, is the less invasive method with promising results for the treatment vesicoureteral reflux.
Objective: To investigate the results of endoscopic injection and compare the efficacy of two agents of different load such as Macroplastique and Vantris.
Methods: Data of patients that underwent endoscopic injection for vesicoureteral reflux treatment at Hospital Nacional de Niños between December 2011 and February 2015 were revised retrospectively. Patients with persistent voiding dysfunction, that had no micturatingcystourethrogram after the endoscopic treatment and incomplete records were excluded. The surgical technique used was STING Classic. The postopertative control was after 3 months and an urinary tract ultrasonography was done, a continuous antibiotic prophylaxis was performed until the control voiding cystourethrogram. Treatment success is defined as the disappearance of reflux in the control voiding cystourethrogram control.
Results: A total of 38 cases were reviewed, of which 33 met the inclusion criteria, 66.6% were girls and 33.3% were boys, 42.4% were documented with bilateral vesicoureteral reflux ( 14 Cases), following 36.36% (12 cases) on the left side and on the right side 21.21% (7 cases). In total 47 ureteral units were evaluated. The Vantris was used in 63.6% of cases and Macroplastique in 27.4%. The majority of patients showed resolution of their subsequent vesicoureteral reflux after the treatment (29 cases: 88%), a smaller amount with persistent reflux (4 cases: 12%) of these, 4 patients persisted with vesicoureteral reflux in a lesser degree than at the moment of the diagnosis, all were submited the endoscopic antireflux injection again, of which 3 were cured and one persisted with vesicoureteral reflux, but of low grade and asymptomatic, being managed conservatively. Conclusions: Correction of vesicoureteral reflux by endoscopic injection with Macroplastique and Vantris is safe, effective and minimally invasive.
Downloads
References
Chertin B, Arafeh WA, Zeldin A, Kocherov S. Preliminary data on endoscopic treatment of vesicoureteric reflux with polyacrylate polyalcohol copolymer (Vantris®): Surgical outcome following single injection. J Pediatr Urol. 2011;7:654-7.
Molitierno J, Scherz H, Kirsch A. Endoscopic treatment of vesicoureteral reflux using dextranomer hyaluronic acid copolymer. J Pediatr Urol. 2008;4:221.
Ormaechea M, Ruiz E, Denes E, Gimenez F, Dénes FT, Moldes J, et al. New tissue bulking agent (polyacrylate polyalcohol) for treating vesicoureteral reflux: Preliminary results in children. J Urol. 2010; 183: 714-7.
Farshid A, Amir A, Mahtab Z, Farhad T, et al. The influence of ureteral orifice configuration on the success rate of endoscopic treatment of vesicoureteral reflux. Advanced Biomedical Research. 2013;2:1-8.
De Badiola F, Soria R, et al. Results of treatment of grades IV and V vesicoureteral reflux with endoscopic injection of polyacrylate polyalcohol copolymer. Pediatric Urology. 2013; 1:1-4.
Kocherov S, Ulman I, et al. Multicenter Survey of Endoscopic Treatment of Vesicoureteral Reflux Using Polyacrylate Polyalcohol Bulking Copolymer (Vantris); Urology. 2014;84:689-693.
Tamer Helmy, Doaa Sharaf, Ahmed Abdel Halim, Ashraf Hafez, and Mohammed Dawaba. Can Distal Ureteral Diameter Predict Reflux Resolution After Endoscopic Injection?; Urology. 2015; 85: 896-899.
Sean T. Watters, Jennifer Sung, Steven J. Skoog; Endoscopic treatment for vesicoureteral reflux: How important is technique? Journal of Pediatric Urology. 2013; 9:1192-1197.
Belman B. Vesicoureteral reflux. Pediatric Clin North Am 1997;44:1171.
Rodríguez J. Reflujo vesicoureteral. Revista Chilena Pediatría. 2000; 7:441446.
Bailey R. Vesicoureteric reflux in healthy infants and children. In: Hodson J, Kincaid-Smith P, editors. Reflux nephropathy. New York: Masson; 1979; 59-61.
Sargent MA. What is the normal prevalence of vesicoureteral reflux? Pediatr Radiol. 2000; 30:587-93.
Rushton HG. The evaluation of acute pyelonephritis and renal scarring with technetium 99mdimercaptosuccinic acid renal scintigraphy: evolving concepts and future directions. Pediatr Nephrol. 1997;11:108-20.
Chand DH, Rhoades T, Poe SA, Kraus S, Strife CF; Incidence and severity of vesicoureteral reflux in children related to age, gender, race and diagnosis. J Urol. 2003; 170: 1548-50.
Horowitz M, Gershbein AB, Glassberg KI; Vesicoureteral reflux in infants with prenatal hydronephrosis confirmed at birth: racial differences. J Urol. 1999; 161: 248-50.
Pinto KJ; Vesicoureteral reflux in the Hispanic child with urinary tract infection. J Urol. 2004; 171: 1266-7.
Garin EH, Campos A, Homsy Y; Primary vesicoureteral reflux: review of current concepts. Pediatr Nephrol. 1998; 12: 249-56.
Campbell-Walsh. Urología. IX Edición. Capítulo 117. Páginas 3423-3481. Elsevier Argentina, S.A. Buenos Aires, Argentina 2008.
Matthew H. Hayn, Marc C. Smaldone, Michael C. Ost, Steven G. Docimo, Minimally Invasive Treatment of Vesicoureteral Reflux; Urol Clin N Am 2008; 35: 477-488.
Downloads
Published
Versions
- 2016-11-10 (2)
- 2016-11-10 (1)
Issue
Section
License
Copyright (c) 2016 Acta Médica Costarricense
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)
