Longterm outcome of Macroplatique injection for treatment of vesicoureteral reflux in children.
BACKGROUND
This study examined our experience with one year follow-up of 20 cases of vesicoureteric reflux in children after treatment with Macroplastique ® injection.


METHODS
A total of 20 children (31 ureters) with primary grades II to V vesicoureteral reflux were treated with subureteral Macroplastique ® injection from 2010 to 2011 and followed for an average of 12 months (range 3 to 24). Vesicoureteral reflux was grade II in 3, III in 7, IV in 9 and V in 12 ureters. Each child underwent pre-operative voiding cystourethrography, abdominopelvic ultrasound, urine analysis/culture, S. creatinine and CBC. Dimercapto-succinic acid scan (DMSA scan) and magnetic resonance urography (MRU) were done in some patients. Voiding cystourethrography at 3 months was done to rule out persistent reflux.


RESULTS
Overall, reflux was corrected in 11 (35.5%) ureters and 9 (45%) children after a single injection. With repeat injection, reflux was corrected in 16 (51.6%) ureters and 11 (55%) children, reflux improved/downgrade in 4 (12.9%) ureters and 2 (10%) children. Correction by grade was 100%, 100%, 9.7%, 9.7% for grades II to V, respectively. There were no surgical complications. None of the cured patients had recurrent reflux during follow-up. There were 9 (45%) children who required open ureteral re-implantation for failed injection.


CONCLUSIONS
Sub-ureteral Macroplastique ® injection therapy could be a primary treatment for low grade VUR (grade III or less) in children because it is simple, safe, effective, less invasive, decreased.
Elrahmany A
EA
Mohamed
Farghal H
FH
Shehata
Elemam A
EA
Abdelbaset
Department of Urology, Alazhar University, Cairo, Egypt.
Mohamed A
MA
Abdelkhalek
Ashraf H
AH
Abdelatif
Husain A
HA
Galal
D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003906:Developing Countries; D004129:Dimethylpolysiloxanes / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004534:Egypt; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D015552:Injections, Intralesional; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013995:Time; D016896:Treatment Outcome; D014567:Urography / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging* / Q000188:drug therapy*
D004129:Dimethylpolysiloxanes; C013830:baysilon