Endoscopic correction of complex cases of vesicoureteral reflux utilizing Vantris as a new non-biodegradable tissue-augmenting substance.
OBJECTIVE
We aimed to evaluate prospectively the efficacy of Vantris as a new non-biodegradable tissue-augmenting substance in children with complex cases of VUR.


METHODS
Over the last 4 years, 37 children (28 female and 9 male) with a mean age of 5.8 ± 3.1 years (mean ± SD) underwent endoscopic correction of complex VUR. A total of 38 renal refluxing units (RRU) was treated as 5 had persistent reflux after open surgery, 16 had duplication, 4 had Hutch diverticulum, 6 had small poorly functioning kidneys (less than 20% of relative renal function) with grade V VUR, 2 had ureterocele after puncture, 3 had persistent stump reflux, 1 had prune belly syndrome, and 1 had urogenital sinus. VUR was Grade I in 2, Grade II in 9, Grade III in 11, Grade IV in 10, and Grade V in 6 RRU, respectively.


RESULTS
The reflux was corrected in 34 (89.4%) RRU after a single injection, after second injection in 2 (5.3%) RRU. In 2 (5.3%) RRU, VUR downgraded to Grade I (1RRU) and Grade II (1RRU) and they were taken off antibiotic prophylaxis. VCUG was performed in 11 (73.3%) of 15 children who completed 1 year and in 3 (33.3%) of 9 who completed 3 years of follow up as a part of the routine protocol. None showed VUR recurrence. US demonstrated normal appearance of kidneys in all patients.


CONCLUSIONS
Our data show that Vantris injection provides a high level of reflux resolution in complex cases of VUR.
Department of Pediatric Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, P.O.B 3235, 91031, Jerusalem, Israel, boris.chertin@gmail.com.
Boris
B
Chertin
Wael
W
Abu Arafeh
Stanislav
S
Kocherov
D020341:Absorbable Implants; D000180:Acrylic Resins; D001672:Biocompatible Materials; D002675:Child, Preschool; D003558:Cystoscopy; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D014718:Vesico-Ureteral Reflux / Q000601:surgery*
D000180:Acrylic Resins; D001672:Biocompatible Materials; C530415:Vantris