Endoscopic subureteral collagen injection for the treatment of vesicoureteral reflux in infants and children.
Between June 1988 and September 1994, 100 girls and 32 boys 2 months to 15.5 years old (average 4.9 years) with 204 refluxing ureteral units were treated by endoscopic subureteral collagen injection. The collagen injected was of bovine origin and cross-linked with glutaraldehyde (Zyplast*). Followup ranged from 3 to 75 months (mean 33). Reflux was absent in 62.7% of cases 3 months after 1 endoscopic subureteral injection. Improvement to reflux grades I and II, generally not requiring further treatment, occurred in a further 15.2% of cases. A total of 66 ureters was injected twice. The overall cure rate after 1 or 2 injections was 79.4% 3 months after injection. There was no correlation between the risk of recurrent reflux and initial degree of reflux. Late recurrence of reflux following a reflux-free period occurred in 11.3% of the 204 units during the observation period, which varied from 3 months to 6 1/4 years. Reflux was absent after 1 or 2 injections, including late recurrence, in 70.6% of cases and in an additional 13.2% recurrent reflux was grade I or II, not necessitating any further treatment. Considering these results, subureteral collagen injection remains an adequate method of treatment for vesicoureteral reflux in children.
Frey
P
P
Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Lutz
N
N
Jenny
P
P
Herzog
B
B
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003094:Collagen / Q000008:administration & dosage*; D003432:Cross-Linking Reagents / Q000008:administration & dosage*; D003558:Cystoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007267:Injections; D008297:Male; D012008:Recurrence; D013997:Time Factors; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
D003432:Cross-Linking Reagents; C048470:glutaraldehyde-cross-linked collagen; D003094:Collagen