title: Endoscopic treatment of vesicoureteral reflux in children with subureteral dextranomer/hyaluronic acid injection: a single-centre, 7-year experience.
abstract: BACKGROUND
  The goals of medical intervention in patients with vesicoureteral reflux are to allow normal renal growth, prevent infections and pyelonephritis, and prevent renal failure. We present our experience with endoscopic treatment of vesicoureteral reflux in children by subureteral dextranomer/hyaluronic acid copolymer injection.
  
  
  METHODS
  Under cystoscopic guidance, dextranomer/hyaluronic acid copolymer underneath the intravesical portion of the ureter in a subureteral or submucosal location was injected in patients undergoing endoscopic correction of vesicoureteral reflux.
  
  
  RESULTS
  A total of 282 patients (120 boys and 162 girls) underwent the procedure. There were 396 refluxed ureters altogether. The mean age of patients was 4.9 years. The mean overall follow-up period was 44 months. Among the 396 ureters treated, 76% were cured with a single injection. A second and third injection raised the cure rate to 93% and 94%, respectively. Twenty-two (6%) ureters failed all 3 injections, and were converted to open surgery.
  
  
  CONCLUSIONS
  Endoscopic treatment of vesicoureteral reflux can be recommended as a first-line therapy for most cases of vesicoureteral reflux, because of the short hospital stay, absence of complications and the high success rate.
authors.affiliation: The Department of Pediatric Surgery, University Hospital Split and Split University School of Medicine, Split, Croatia.
authors.forename: Mihovil
authors.initials: M
authors.lastname: Biočić
authors.forename: Jakov
authors.initials: J
authors.lastname: Todorić
authors.forename: Dražen
authors.initials: D
authors.lastname: Budimir
authors.forename: Andrea
authors.initials: A
authors.lastname: Cvitković Roić
authors.forename: Zenon
authors.initials: Z
authors.lastname: Pogorelić
authors.forename: Ivo
authors.initials: I
authors.lastname: Jurić
authors.forename: Tomislav
authors.initials: T
authors.lastname: Šušnjar
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D003911:Dextrans / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007223:Infant; D007267:Injections; D008297:Male; D019233:Retreatment; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018666:Ureteroscopy; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery*
chemical_list: D003911:Dextrans; C094535:deflux; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid