title: A comparison of the double hydrodistention implantation technique (HIT) and the HIT with a polyacrylate/polyalcohol copolymer (PPC) for the endoscopic treatment of primary vesicoureteral reflux.
abstract: OBJECTIVE
  We aimed to compare the success rates of the double hydrodistention implantation technique (HIT) and the HIT with a polyacrylate/polyalcohol copolymer (PPC) for the treatment of primary vesicoureteral reflux (VUR) with a new nonbiodegradable tissue-augmenting substance (Vantris, Promedon, Cordoba, Argentina).
  
  
  METHODS
  Between January 2011 and December 2012, fifty-two children who underwent subureteric injection for primary VUR are included. The children were randomly separated into two groups, the HIT and the double HIT groups, according to the type of injection. Success was defined as no reflux on a follow-up voiding cystourethrogram (VCUG) after 6 months. The patients were evaluated according to sex, age, grade of reflux, number of injections, and injected volume, and the radiological success rates were compared.
  
  
  RESULTS
  Fifty-two patients underwent an endoscopic injection for primary grade III-V VUR. The HIT group consisted of 26 patients with 33 ureters, and the double HIT group consisted of 26 patients with 35 ureters. There were no significant differences in terms of the sex, ages, VUR grades, bilaterality between the two groups. The mean injected volumes were ml 1.12 (1.02-1.22) in the HIT group and 1.24 ml (95 % CI 1.10-1.38) in the double HIT group. The reflux was resolved in 21/33 (63.6 %) ureters in the HIT group and in 30/35 (85.7 %) ureters in the double HIT group, (p < 0.05). We had only one complication. This patient in the double HIT group, developed bilateral hydronephrosis and oliguric renal failure requiring open reimplantation at the sixth month.
  
  
  CONCLUSIONS
  We observed successful results double HIT method with PPC in Grade III-V reflux, but the long-term follow-up of patients is needed for hydronephrosis. As the double HIT treatment leads to a higher success rate, its use is preferable.
authors: Pediatric Surgery Department, Sisli Etfal Education and Training Hospital, Istanbul, Turkey.
authors: Melih
authors: M
authors: Akin
authors: Basak
authors: B
authors: Erginel
authors: Cetin Ali
authors: CA
authors: Karadag
authors: Abdullah
authors: A
authors: Yildiz
authors: Gül Sumru
authors: GS
authors: Ozçelik
authors: Nihat
authors: N
authors: Sever
authors: Nimetullah Mete
authors: NM
authors: Genc
authors: Ali Ihsan
authors: AI
authors: Dokucu
mesh_terms: D000180:Acrylic Resins / Q000008:administration & dosage*; D001672:Biocompatible Materials / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004210:Dissection / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007267:Injections; D008297:Male; D019919:Prosthesis Implantation / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter; D018666:Ureteroscopy / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000628:therapy
chemical_list: D000180:Acrylic Resins; D001672:Biocompatible Materials; C530415:Vantris