Endoscopic correction of vesicoureteral reflux in children using autologous chondrocytes: preliminary results.
OBJECTIVE
Previous approaches to the endoscopic correction of vesicoureteral reflux have used foreign bulking substances, raising concern regarding safety and long-term efficacy. We describe the results of a clinical trial using transurethral injection of autologous chondrocytes to correct vesicoureteral reflux in children.


METHODS
A total of 29 children (46 ureters) with grades II to IV vesicoureteral reflux were treated at 2 sites. Each child underwent cystoscopy and ear cartilage biopsy at the initial setting. Chondrocytes were grown in culture for 6 weeks. Patients then returned for transurethral injection of chondrocytes into the bladder trigone to correct reflux. Ultrasound was performed 1 month and radionuclide cystography was done 3 months postoperatively to confirm reflux resolution. When reflux persisted, repeat treatment with stored chondrocytes was offered.


RESULTS
Initial chondrocyte injection corrected reflux in 26 of the 46 ureters (57%), while secondary injection was successful in 12 of 19 (63%). Overall reflux was corrected in 38 of the 46 ureters (83%) and in 24 of the 29 patients (83%). There were no significant complications.


CONCLUSIONS
Transurethral injection of autologous chondrocytes to correct vesicoureteral reflux in children appears to be an effective and safe technique that holds promise for treating this congenital abnormality in a minimally invasive fashion.
Diamond
D A
DA
Department of Urology, Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Caldamone
A A
AA
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019902:Chondrocytes; D005260:Female; D006801:Humans; D007223:Infant; D007267:Injections; D008297:Male; D018666:Ureteroscopy; D014718:Vesico-Ureteral Reflux / Q000628:therapy*