New tissue bulking agent (polyacrylate polyalcohol) for treating vesicoureteral reflux: preliminary results in children.
OBJECTIVE
We report the preliminary results of endoscopic treatment of vesicoureteral reflux in children using polyacrylate polyalcohol copolymer.


METHODS
We performed a prospective multicenter review of pediatric patients treated with subureteral injection of a new nonabsorbable substance. Only patients with 1 year of followup were included.


RESULTS
A total of 83 patients underwent injection of polyacrylate polyalcohol copolymer at our institutions between 2005 and 2006. Among this group 18 males and 43 females with a median age of 58 months (range 9 months to 18 years) completed 1 year of followup. Reflux was bilateral in 27 patients (44.3%) and unilateral in 34 (55.7%). Number of injected ureters was 88. Reflux grade was V in 3 ureters (3.4%), IV in 12 (13.6%), III in 41 (46.6%) and II in 32 (36.4%). Mean +/- SD injected volume per unit was 0.76 +/- 0.43 ml. Median followup was 20 months (range 16 to 24). Complications after injection included dysuria in 6 patients (9.8%), fever in 3 (4.9%) and lumbar pain in 4 (6.6%). Reflux was eliminated in 78 renal units (88.6%), decreased to grade I in 6 (6.8%) and persisted in 4 (4.5%). Ureteral obstruction developed in 1 patient and was treated operatively. Overall success rate was 83.6%.


CONCLUSIONS
Polyacrylate polyalcohol copolymer can be used to treat vesicoureteral reflux with comparable efficacy to other substances currently used, with a low rate of complications.
Ormaechea
M
M
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Ruiz
E
E
Denes
E
E
Gimenez
F
F
Dénes
F T
FT
Moldes
J
J
Amarante
A
A
Pioner
G
G
Dekermacher
S
S
de Badiola
F
F
D000180:Acrylic Resins; D000293:Adolescent; D001672:Biocompatible Materials; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
D000180:Acrylic Resins; D001672:Biocompatible Materials; C530415:Vantris