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Related Experiment Videos

[Complex vesicoureteral reflux. Our experience].

E Argüelles Salido1, F García Merino, A Millán López

  • 1Servicio de Urología, Unidad de Urología Infantil, Hospital Universitario Virgen del Rocío, Sevilla. earguelles@telefonica.net

Actas Urologicas Espanolas
|September 27, 2005
PubMed
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Endoscopic treatment for vesicoureteral reflux (VUR) is highly effective, with success rates increasing after multiple injections. This minimally invasive approach is recommended as a primary treatment option for VUR in children.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Urologic Oncology

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children, characterized by the abnormal backward flow of urine from the bladder to the ureters.
  • Endoscopic treatment has emerged as a less invasive alternative to traditional open surgery for managing VUR.
  • Complex VUR cases present unique challenges, necessitating evaluation of treatment efficacy and influencing factors.

Purpose of the Study:

  • To analyze the proportion of complex reflux cases among all patients undergoing endoscopic treatment for VUR.
  • To determine the success rate of endoscopic treatment for complex VUR.
  • To assess the influence of VUR grade on treatment outcomes.

Main Methods:

  • A retrospective review of 74 patients with complex VUR treated via endoscopic injection between 1992 and 2003.

Related Experiment Videos

  • Utilized three different injectable substances: polytetrafluoroethylene (PTFE), polydimethylsiloxane (PDMS), and dextranomer-hyaluronic acid copolymer (Deflux).
  • Post-injection assessment included voiding cystourethrograms at 3 and 9 months, with success defined as Grade 0 or I reflux.

    • Main Results:

    • Successful resolution of VUR was achieved in 86.25% after the first injection, increasing to 93.75% after the second and 96.25% after the third.
    • Treatment success rates varied by VUR grade: 88.9% for Grade II, 83.3% for Grade III, and 100% for Grade IV.
    • Overall, endoscopic subureteral injection demonstrated high efficacy in managing complex VUR.

    Conclusions:

    • Subureteral injection of various agents (Teflon, Macroplastique, Deflux) is an effective treatment for most VUR cases, including complex presentations.
    • The study supports endoscopic injection as a valuable first-line therapy for VUR.
    • Reflux grade influences treatment outcomes, with higher grades showing slightly lower initial success rates but still achieving high overall resolution.