Treatment of vesicoureteral reflux in children using stabilized non-animal hyaluronic acid/dextranomer gel (NASHA/DX): A long-term observational study
2007 (English)In: Journal of Pediatric Urology, ISSN 1477-5131, Vol. 3, no 2, 80-85 p.Article in journal (Refereed) Published
OBJECTIVE: Vesicoureteral reflux (VUR) can be treated with open surgery, antibiotic therapy or endoscopic injection. A goal in children is to reduce the incidence of febrile urinary tract infections (UTIs). The present long-term observational study investigated outcomes and experiences of endoscopic treatment with stabilized non-animal hyaluronic acid/dextranomer, NASHAtrade mark/Dx. PATIENTS AND METHODS: Children treated with NASHA/Dx between 1993 and 1998 were sent a questionnaire by mail in 2005. Patients included in the study (n=231) had VUR grade III-V before treatment and grade 0-II afterwards. Patients completed 21 questions, with parental assistance if required. The questionnaire assessed clinical outcome, and the attitudes of both patients and their parents to their experiences of treatment with NASHA/Dx gel. Patients reporting UTI after treatment were contacted and their records analyzed. RESULTS: Questionnaires were completed by 179 eligible patients. Most (72%) received a single injection of NASHA/Dx gel, and all experienced febrile UTI before treatment. After treatment, 45 patients (25%) experienced UTI; 25 of these reported fever. Patient records and telephone interviews revealed no evidence of febrile UTI in 19 cases; febrile UTI was confirmed in six cases, an incidence of 3.4%. When asked about the worst aspect of VUR treatment, 9% indicated treatment with NASHA/Dx compared to 19% for medication and 72% for voiding cystourethrogram (VCUG); parent-rated responses were 19%, 24% and 57%, respectively. CONCLUSIONS: Endoscopic treatment with NASHA/Dx gel was associated with a low number of febrile UTIs following treatment, viewed positively and considered less bothersome than medication or VCUG. These findings support this treatment as a primary intervention for VUR.
Place, publisher, year, edition, pages
2007. Vol. 3, no 2, 80-85 p.
Vesicoureteral reflux, Children, NASHA/Dx, Follow-up, Endoscopic injection
Medical and Health Sciences
Research subject Urology
IdentifiersURN: urn:nbn:se:uu:diva-105015DOI: 10.1016/j.jpurol.2006.08.001PubMedID: 18947708OAI: oai:DiVA.org:uu-105015DiVA: diva2:220347