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A New Bioimplant for the Endoscopic Treatment of Vesicoureteral Reflux: Experimental and Short-term Clinical Results

1995; Lippincott Williams & Wilkins; Volume: 154; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(01)67168-4

1527-3792

Arne Stenberg, Göran Läckgren,

Ureteral procedures and complications

No AccessJournal of UrologyVesicoureteral Reflux1 Aug 1995A New Bioimplant for the Endoscopic Treatment of Vesicoureteral Reflux: Experimental and Short-term Clinical Results Arne Stenberg and Goran Lackgren Arne StenbergArne Stenberg and Goran LackgrenGoran Lackgren View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)67168-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail We investigated the safety and clinical effects of a new biocompatible, biodegradable treatment, the Deflux* Qvestor AB, Uppsala, Sweden. system (dextranomer microspheres in sodium hyaluronan solution), for the endoscopic treatment of grades III and IV vesicoureteral reflux. In preclinical safety studies in pigs histopathological examination demonstrated excellent tolerance. Two weeks after submucous implantation in the pig bladder early ingrowth of fibroblasts and recently generated collagen were noted at the implantation sites. At 14 weeks of followup this ingrowth had slightly increased. Long-term followup in rats showed that the volume of subcutaneous implants was slightly reduced (23 percent) 1 year after implantation. In a clinical study we investigated the implantation technique and the short (3 months) and long-term (1 year) effects of Deflux implantation in 75 children (101 ureters) with grades III and IV vesicoureteral reflux. We report data from up to 3 months of followup. Implant volumes of 0.4 to 1.0 ml. were sufficient to create distinct boluses and crescent-like ureteral orifices. Although viscous, due to its viscoelastic properties the substance was easy to inject in a well controlled manner. At cystography 3 months later reflux had resolved in 68 percent of implants, was reduced to grades I and II in 13 percent of implants and was unchanged in 19 percent of treated ureters (grades III and IV reflux). No signs of ureteral obstruction or adverse reactions were noted. Results from 1 year of followup will be reported later. Our results indicate that the dextranomer microspheres act as micro-carriers that promote ingrowth of fibroblasts and generate new collagen. We conclude that the Deflux system may represent a new, safe, simple alternative to endoscopic treatment of vesicoureteral reflux in children. References 1 : Injectable microparticulate silicone: a new treatment to correct vesicoureteric reflux. Eur. Urol.July, 1992; . Google Scholar 2 : Subureteral collagen injection for the endoscopic treatment of vesicoureteral reflux in children. Followup study of 97 treated ureters and histological analysis of collagen implants. J. Urol., part 21992; 148: 718. 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Google Scholar Section of Urology, Department of Pediatric Surgery, University Children's Hospital, Uppsala, Sweden.© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byRamsay S, Blais A, Morin F, Moore K, Cloutier J and Bolduc S (2016) Polyacrylamide Hydrogel as a Bulking Agent for the Endoscopic Treatment of Vesicoureteral Reflux: Long-Term Results and SafetyJournal of Urology, VOL. 197, NO. 3 Part 2, (963-967), Online publication date: 1-Mar-2017.Moore K and Bolduc S (2018) Prospective Study of Polydimethylsiloxane vs Dextranomer/Hyaluronic Acid Injection for Treatment of Vesicoureteral RefluxJournal of Urology, VOL. 192, NO. 6, (1794-1800), Online publication date: 1-Dec-2014.Cloutier J, Blais A, Moore K and Bolduc S (2018) Prospective Study Using a New Bulking Agent for the Treatment of Vesicoureteral Reflux: Polyacrylamide HydrogelJournal of Urology, VOL. 190, NO. 3, (1034-1037), Online publication date: 1-Sep-2013.Ben-Meir D, Morgenstern S, Sivan 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Volume 154Issue 2August 1995Page: 800-803 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Arne Stenberg More articles by this author Goran Lackgren More articles by this author Expand All Advertisement PDF downloadLoading ...