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Endoscopic Treatment With Stabilized Nonanimal Hyaluronic Acid/Dextranomer Gel is Effective in Vesicoureteral Reflux Associated With Bladder Dysfunction

2007; Lippincott Williams & Wilkins; Volume: 177; Issue: 3 Linguagem: Inglês

10.1016/j.juro.2006.10.094

1527-3792

Göran Läckgren, Erik Sköldenberg, Arne Stenberg,

Urinary Bladder and Prostate Research

No AccessJournal of UrologyPediatric urology1 Mar 2007Endoscopic Treatment With Stabilized Nonanimal Hyaluronic Acid/Dextranomer Gel is Effective in Vesicoureteral Reflux Associated With Bladder Dysfunction Göran Läckgren, Erik Sköldenberg, and Arne Stenberg Göran LäckgrenGöran Läckgren More articles by this author , Erik SköldenbergErik Sköldenberg More articles by this author , and Arne StenbergArne Stenberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2006.10.094AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract 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. References 1 : Vesico-ureteric reflux: occurrence and long-term risks. Acta Paediatr1999; 88: 22. Google Scholar 2 : A critical appraisal of antibiotic prophylaxis and endoscopic injection for vesicoureteral reflux. Issues in Urology2006; 18: 123. Google Scholar 3 : Endoscopic treatment of vesicoureteral reflux and urinary incontinence in children. AUA Update Series2003; vol. 22. lesson 37. Google Scholar 4 : Treatment of vesico-ureteric reflux: a new algorithm based on parental preference. BJU Int2003; 92: 285. 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Link, Google Scholar Section of Urology, University Children’s Hospital, Uppsala, Sweden© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited byJalkanen J, Heikkilä J, Kyrklund K and Taskinen S (2016) Controlled Outcomes for Achievement of Urinary Continence among Boys Treated for Posterior Urethral ValvesJournal of Urology, VOL. 196, NO. 1, (213-218), Online publication date: 1-Jul-2016.Puri P, Kutasy B, Colhoun E and Hunziker M (2012) Single Center Experience with Endoscopic Subureteral Dextranomer/Hyaluronic Acid Injection as First Line Treatment in 1,551 Children with Intermediate and High Grade Vesicoureteral RefluxJournal of Urology, VOL. 188, NO. 4S, (1485-1489), Online publication date: 1-Oct-2012.Bar-Yosef Y, Castellan M, Joshi D, Labbie A and Gosalbez R (2011) Salvage Dextranomer-Hyaluronic Acid Copolymer for Persistent Reflux After Ureteral Reimplantation: Early Success RatesJournal of Urology, VOL. 185, NO. 6S, (2531-2535), Online publication date: 1-Jun-2011.Traxel E, DeFoor W, Reddy P, Sheldon C and Minevich E (2009) Risk Factors for Urinary Tract Infection After Dextranomer/Hyaluronic Acid Endoscopic InjectionJournal of Urology, VOL. 182, NO. 4S, (1708-1713), Online publication date: 1-Oct-2009.Sedberry-Ross S, Rice D, Pohl H, Belman A, Majd M and Rushton H (2008) Febrile Urinary Tract Infections in Children With an Early Negative Voiding Cystourethrogram After Treatment of Vesicoureteral Reflux With Dextranomer/Hyaluronic AcidJournal of Urology, VOL. 180, NO. 4S, (1605-1610), Online publication date: 1-Oct-2008. Volume 177 Issue 3 March 2007 Page: 1124-1129 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsNASHA-Dx copolymervesico-ureteral refluxbladderendoscopychildMetrics Author Information Göran Läckgren More articles by this author Erik Sköldenberg More articles by this author Arne Stenberg More articles by this author Expand All Advertisement PDF downloadLoading ...