Endoscopic treatment of vesicoureteral reflux with collagen: preliminary report and cost analysis.
OBJECTIVE
We determined therapeutic and operative cost efficacy of endoscopic collagen injection for vesicoureteral reflux.


METHODS
We performed a multicenter study of 10 male and 23 female sequential patients (45 renal units) with vesicoureteral reflux and a surgical indication. Patients were skin tested with collagen and when negative, they underwent endoscopic injection. Renal ultrasound/cystography was done 3 months after treatment. Cost analysis was performed at 1 institution.


RESULTS
Reflux was grade I in 2 renal units, II in 18, III in 15 and IV in 10. The majority of cases were single systems with primary reflux. We performed 1 treatment in 32 renal units, 2 in 6, 3 in 6 and 4 in 1. Cure was evident in 31 of 38 renal units (81.6%) and 21 of 27 patients (78%) 3 months after the last injection. Patient morbidity was minimal. Operative cost per renal unit was $1,599.68 for collagen injection and $9,144.47 for reimplantation.


CONCLUSIONS
Endoscopic injection of collagen is effective treatment for vesicoureteral reflux. Furthermore, it causes minimal morbidity and may effect cost savings in health care management.
Leonard
M P
MP
University of Manitoba, Winnipeg, Canada.
Decter
A
A
Mix
L W
LW
Johnson
H W
HW
Coleman
G U
GU
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003094:Collagen / Q000627:therapeutic use*; D003365:Costs and Cost Analysis; D004724:Endoscopy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019736:Prostheses and Implants / Q000191:economics; D014718:Vesico-Ureteral Reflux / Q000191:economics / Q000628:therapy*
D003094:Collagen