title: Subureteral Injection with Small-Size Dextranomer/Hyaluronic Acid Copolymer: Is It Really Efficient?
abstract: The aim of this study was to evaluate the clinical results of patients with vesicoureteral reflux, which were treated with subureteral injection of small-size (80-120μm) dextranomer/hyaluronic acid copolymer (Dx/HA). Data of 75 children (105 renal units) who underwent STING procedure with small-size Dx/HA for the treatment of vesicoureteral reflux (VUR) in our clinic between 2008 and 2012 were retrospectively analyzed. Preoperative reflux grade and side, injection indication, postoperative urinary infections and urinary symptoms, voiding cystourethrogram, and renal scintigraphy results were evaluated. The success rate of the procedure was 100% in patients with grades 1 and 2 reflux, 91% in patients with grade 3 reflux, and 82.6% in patients with grade 4. Overall success rate of the treated patients was 97%. Endoscopic subureteric injection with Dx/HA procedure has become a reasonable minimally invasive alternative technique to open surgery, long-term antibiotic prophylaxis, and surveillance modalities in treatment of VUR in terms of easy application, low costs and complication rates, and high success rates. Injection material composed of small-size dextranomer microspheres seems superior to normal size Dx/HA, together with offering similar success with low cost.
authors.affiliation: Department of Urology, Faculty of Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey.
authors.forename: Iyimser
authors.identifier: 0000-0002-4653-576X
authors.initials: I
authors.lastname: Üre
authors.affiliation: Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Serhat
authors.identifier: 0000-0003-2075-0098
authors.initials: S
authors.lastname: Gürocak
authors.affiliation: Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Özgür
authors.initials: Ö
authors.lastname: Tan
authors.affiliation: Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Amirali
authors.initials: A
authors.lastname: Farahvash
authors.affiliation: Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Senol
authors.affiliation: Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Gümüstas
authors.affiliation: Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Irfan
authors.initials: I
authors.lastname: Atay
authors.affiliation: Department of Urology, Faculty of Medicine, Gazi University, Ankara, Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Deniz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003911:Dextrans / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000209:etiology / Q000517:prevention & control; D014718:Vesico-Ureteral Reflux / Q000503:physiopathology / Q000601:surgery
chemical_list: D003911:Dextrans; C487487:dextranomer-hyaluronic acid copolymer; D006820:Hyaluronic Acid