The outcomes of two different bulking agents (dextranomer hyaluronic acid copolymer and polyacrylate-polyalcohol copolymer) in the treatment of primary vesico-ureteral reflux.
OBJECTIVE
Subureteral injection of bulking agents in the endoscopic treatment of vesicoureteral reflux is widely accepted therapy with high success rates. Although the grade of vesicoureteric reflux and experience of surgeon is the mainstay of this success, the characteristics of augmenting substances may have an effect particularly in the long term. In this retrospective study, we aimed to evaluate the clinical outcomes of the endoscopic treatment of vesicoureteric reflux (VUR) with two different bulking agents: Dextranomer/hyaluronic acid copolymer (Dx/HA) and Polyacrylate polyalcohol copolymer (PPC).


METHODS
A total 80 patients (49 girls and 31 boys) aged 1-12 years (mean age 5.3 years) underwent endoscopic subureteral injection for correction of VUR last six years. The patients were assigned to two groups: subureteral injections of Dx/HA (45 patients and 57 ureters) and PPC (35 patients and 45 ureters). VUR was grade II in 27 ureters, grade III in 35, grade IV in 22 and grade V in 18 ureters.


RESULTS
VUR was resolved in 38 (66.6%) of 57 ureters and this equates to VUR correction in 33 (73.3%) of the 45 patients in Dx/HA group. In PPC group, overall success rate was 88.8% (of 40 in 45 ureters). Thus, Thus, this equates to VUR correction in 31 (88.5%) of the 35 patients.


CONCLUSIONS
Our short term data show that two different bulking agent injections provide a high level of reflux resolution and this study revealed that success rate of PPC was significantly higher than Dx/HA with less material.
Department of Pediatric Surgery, Mersin University, School of Medicine, Mersin, Turkey.
Hakan
H
Taşkinlar
Department of Pediatric Surgery, Mersin University, School of Medicine, Mersin, Turkey.
Dincer
D
Avlan
Department of Pediatric Nephrology, Mersin University, School of Medicine, Mersin, Turkey.
Gokhan Berktug
GB
Bahadir
Department of Pediatric Surgery, Mersin University, School of Medicine, Mersin, Turkey.
Ali
A
Delibaş
Department of Pediatric Surgery, Mersin University, School of Medicine, Mersin, Turkey.
Ali
A
Nayci
D000179:Acrylates / Q000627:therapeutic use*; D000180:Acrylic Resins / Q000627:therapeutic use*; D001672:Biocompatible Materials / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003911:Dextrans / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007223:Infant; D007267:Injections / Q000379:methods; D008297:Male; D011108:Polymers / Q000627:therapeutic use*; D019736:Prostheses and Implants; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter; D018666:Ureteroscopy / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
D000179:Acrylates; D000180:Acrylic Resins; D001672:Biocompatible Materials; D003911:Dextrans; D011108:Polymers; C530415:Vantris; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid