title: Multicenter survey of endoscopic treatment of vesicoureteral reflux using polyacrylate-polyalcohol bulking copolymer (Vantris).
abstract: OBJECTIVE
  To evaluate an outcome of endoscopic correction of vesicoureteral reflux (VUR) using Vantris (Promedon, Cordoba, Argentina) in terms of its effectiveness and morbidity in a multicenter study.
  
  
  METHODS
  From 2009 to 2013, 611 patients (210 boys and 401 girls) with a mean age of 3.56 years (range, 1 month-18 years) were treated at 7 centers worldwide endoscopically with Vantris injection. VUR was unilateral in 413 and bilateral in 198 patients comprising 809 renal refluxing units (RRUs). Of these, primary VUR was present in 674 RRUs (83.3%) and 135 (16.7%) were complex cases. Reflux was grades I-V in 24 (2.96%), 123 (15.2%), 451 (55.8%), 158 (19.5%), and 53 (6.6%) RRUs respectively. The follow-up continued from 6 to 54 months.
  
  
  RESULTS
  Reflux resolved in 759 RRUs (93.8%) after first Vantris injection, in 26 (3.1%) after second, and in 6 (0.7%) after third injection, respectively. VUR improved to grade I after 1 or 2 injections in 5 ureters (0.6%), which needed no further treatment. Thirteen ureters (1.6%) failed endoscopic correction and required ureteral reimplantation. Vesicoureteral junction obstruction requiring ureteral reimplantation developed in 6 ureters (0.7%) and in 4 (0.5%) required stent insertion. Twenty-three patients (3.8%) suffered afebrile urinary tract infection. Seven (1.2%) developed febrile urinary tract infection. None of the studied patients demonstrated VUR recurrence on voiding cystourethrography.
  
  
  CONCLUSIONS
  The results of this multicenter survey confirm that endoscopic subureteral Vantris injection is a simple, safe, and effective outpatient procedure for treating all grades of VUR.
authors.affiliation: Department of Pediatric Urology, Shaare Zedek Medical Center, Jerusalem, Israel.
authors.forename: Stanislav
authors.initials: S
authors.lastname: Kocherov
authors.affiliation: Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ulman
authors.affiliation: Filatov Pediatric Hospital, Moscow, Russia.
authors.forename: Sergey
authors.initials: S
authors.lastname: Nikolaev
authors.affiliation: Pediatric Hospital, Buenos Aires, Argentina.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Corbetta
authors.affiliation: State Research Institute of Urology, Moscow, Russia.
authors.forename: Yuriy
authors.initials: Y
authors.lastname: Rudin
authors.affiliation: Clinical Center, Nis, Serbia.
authors.forename: Andjelka
authors.initials: A
authors.lastname: Slavkovic
authors.affiliation: Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Dokumcu
authors.affiliation: Ege University Faculty of Medicine, Izmir, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Avanoglu
authors.affiliation: Filatov Pediatric Hospital, Moscow, Russia.
authors.forename: Ludmila
authors.initials: L
authors.lastname: Menovshchikova
authors.affiliation: Filatov Pediatric Hospital, Moscow, Russia.
authors.forename: Semen
authors.initials: S
authors.lastname: Kovarskiy
authors.affiliation: Filatov Pediatric Hospital, Moscow, Russia.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Skliarova
authors.affiliation: Pediatric Hospital, Buenos Aires, Argentina.
authors.forename: Santiago
authors.initials: S
authors.lastname: Weller
authors.affiliation: Pediatric Hospital, Buenos Aires, Argentina.
authors.forename: Juan I
authors.initials: JI
authors.lastname: Bortagaray
authors.affiliation: Pediatric Hospital, Buenos Aires, Argentina.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Lopez
authors.affiliation: Pediatric Hospital, Buenos Aires, Argentina.
authors.forename: Víctor
authors.initials: V
authors.lastname: Durán
authors.affiliation: Pediatric Hospital, Buenos Aires, Argentina.
authors.forename: Carol
authors.initials: C
authors.lastname: Burek
authors.affiliation: Pediatric Hospital, Buenos Aires, Argentina.
authors.forename: Cristian
authors.initials: C
authors.lastname: Sager
authors.affiliation: State Research Institute of Urology, Moscow, Russia.
authors.forename: Dmitriy
authors.initials: D
authors.lastname: Maruhnenko
authors.affiliation: State Research Institute of Urology, Moscow, Russia.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Garmanova
authors.affiliation: State Research Institute of Urology, Moscow, Russia.
authors.forename: Aliev
authors.initials: A
authors.lastname: Djamal
authors.affiliation: Clinical Center, Nis, Serbia.
authors.forename: Zorica
authors.initials: Z
authors.lastname: Jovanovic
authors.affiliation: Clinical Center, Nis, Serbia.
authors.forename: Nikola
authors.initials: N
authors.lastname: Vacic
authors.affiliation: Department of Pediatric Urology, Shaare Zedek Medical Center, Jerusalem, Israel; St Josef Hospital, East Jerusalem, Palestinian Authority.
authors.forename: Wael
authors.initials: W
authors.lastname: Abu Arafeh
authors.affiliation: Department of Pediatric Urology, Shaare Zedek Medical Center, Jerusalem, Israel. Electronic address: boris.chertin@gmail.com.
authors.forename: Boris
authors.initials: B
authors.lastname: Chertin
mesh_terms: D000179:Acrylates / Q000737:chemistry*; D000180:Acrylic Resins / Q000737:chemistry*; D000293:Adolescent; D000438:Alcohols / Q000737:chemistry*; D001672:Biocompatible Materials / Q000737:chemistry; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013997:Time Factors; D018666:Ureteroscopy / Q000379:methods; D014521:Urethra / Q000473:pathology; D001743:Urinary Bladder / Q000473:pathology; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
chemical_list: D000179:Acrylates; D000180:Acrylic Resins; D000438:Alcohols; D001672:Biocompatible Materials; C530415:Vantris