Endoscopic Treatment With Stabilized Nonanimal Hyaluronic Acid/Dextranomer Gel is Effective in Vesicoureteral Reflux Associated With Bladder Dysfunction
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
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.
NASHA-Dx copolymer, vesico-ureteral reflux, bladder, endoscopy, child
Medical and Health Sciences
Research subject Urology
IdentifiersURN: urn:nbn:se:uu:diva-104908DOI: 10.1016/j.juro.2006.10.094ISI: 000244211600080PubMedID: 17296428OAI: oai:DiVA.org:uu-104908DiVA: diva2:220258