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Endoscopic Treatment With Stabilized Nonanimal Hyaluronic Acid/Dextranomer Gel is Effective in Vesicoureteral Reflux Associated With Bladder Dysfunction
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Paediatric Surgery.
2007 (English)In: Journal of Urology, ISSN 0022-5347, E-ISSN 1527-3792, Vol. 177, no 3, 1124-1129 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Endoscopic injection of stabilized nonanimal hyaluronic acid/dextranomer gel is an established treatment for vesicoureteral reflux in children. We performed a subgroup analysis to assess this treatment in reflux associated with bladder dysfunction. MATERIALS AND METHODS: Of 308 consecutive children treated endoscopically with stabilized nonanimal hyaluronic acid/dextranomer gel for dilating vesicoureteral reflux 54 were observed retrospectively to have bladder dysfunction. Initial followup consisted of voiding cystourethrogram at 3 and 12 months after injection, with positive response defined as reflux grade 0 or I. At 7 to 12 years following treatment patient charts were checked for urinary tract infections and bladder dysfunction, and a followup survey (postal questionnaire) was administered. RESULTS: A positive response to therapy (cure) was observed in 45 children (83%) after 1 to 3 endoscopic treatments. Concurrently, bladder dysfunction had resolved in 32 patients (59%). After the last stabilized nonanimal hyaluronic acid/dextranomer gel implantation 45 patients (83%) were free of urinary tract infections. Questionnaire results were similar to chart based findings. Stabilized nonanimal hyaluronic acid/dextranomer gel implantation was well tolerated, with no associated complications. CONCLUSIONS: Endoscopic treatment with stabilized nonanimal hyaluronic acid/dextranomer gel appears to be similarly effective in patients with vesicoureteral reflux with and without bladder dysfunction. These data indicate that bladder dysfunction should not be considered a contraindication to endoscopic treatment for reflux.

Place, publisher, year, edition, pages
2007. Vol. 177, no 3, 1124-1129 p.
Keyword [en]
NASHA-Dx copolymer, vesico-ureteral reflux, bladder, endoscopy, child
National Category
Medical and Health Sciences
Research subject
Urology
Identifiers
URN: urn:nbn:se:uu:diva-104908DOI: 10.1016/j.juro.2006.10.094ISI: 000244211600080PubMedID: 17296428OAI: oai:DiVA.org:uu-104908DiVA: diva2:220258
Available from: 2009-05-30 Created: 2009-05-30 Last updated: 2017-12-13Bibliographically approved

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