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[The treatment of vesicoureteral reflux]

Ribeiro de Castro1, Pedro Massó, Armando Reis

  • 1Servicio de Urología, Hospital María Pia, Porto, Portugal. luis.joao.castro@gmail.com

Archivos Espanoles De Urologia
|May 22, 2008
PubMed

Insights

Subureteral injection of dextranomer and hyaluronic acid copolymer effectively treats pediatric vesicoureteral reflux (VUR). This minimally invasive endoscopic procedure offers a safe and well-tolerated surgical option with a high success rate, becoming a preferred treatment for VUR.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Urologic Pathology

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children, often diagnosed during urinary tract infection (UTI) investigations or prenatal hydronephrosis screening.
  • The management of VUR has evolved, with minimally invasive endoscopic techniques gaining prominence.
  • Subureteral injection of bulking agents represents a significant advancement in VUR treatment options.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of endoscopic treatment for VUR using subureteral injection of dextranomer and hyaluronic acid copolymer.
  • To present surgical treatment results for VUR in children between 2001 and 2006.

Main Methods:

  • Retrospective study of endoscopic VUR treatment with dextranomer and hyaluronic acid copolymer (Copol-Dx/AH) from July 2001 to December 2006.
  • Inclusion criteria: children with VUR grade II or greater undergoing treatment.
  • Cure defined as no reflux or grade I VUR on control voiding cystourethrography (VCUG), with subsequent discontinuation of antibiotic prophylaxis.

Main Results:

  • A total of 661 children were treated; 607 endoscopically and 54 with the Cohen technique.
  • Endoscopic treatment involved 437 females and 170 males, with bilateral VUR in 37.7% of cases.
  • Success rates were 70% after the first treatment, 75% after the second, and 78% after the third.

Conclusions:

  • Subureteral injection of dextranomer and hyaluronic acid copolymer is an effective treatment for pediatric VUR, regardless of reflux grade.
  • The procedure is simple, safe, well-tolerated, and associated with low morbidity.
  • Endoscopic treatment is currently the preferred surgical option for most children with VUR.
Abstract

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