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Injection therapy: advancing the treatment of vesicoureteral reflux

Andrew Kirsch1, Terry Hensle, Hal Scherz

  • 1Department of Pediatric Urology, Children's Healthcare of Atlanta, Emory University School of Medicine, 5445 Meridian Mark Road, Atlanta, GA 30342, USA. akirschmd@aol.com

Journal of Pediatric Urology
|October 25, 2008
PubMed

Insights

Endoscopic injection using NASHA/Dx gel offers a safe and effective first-line treatment for pediatric vesicoureteral reflux (VUR), showing success rates comparable to surgery.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery

Background:

  • Vesicoureteral reflux (VUR) is a common congenital condition in children, often diagnosed after urinary tract infections.
  • Current VUR treatments include observation, antibiotics, open surgery, and endoscopic injection.

Purpose of the Study:

  • To review evidence and clinical experience regarding VUR treatment options.
  • To evaluate endoscopic injection, specifically with NASHA/Dx gel, as a primary VUR treatment.

Main Methods:

  • Literature review of VUR treatment evidence.
  • Clinical experience with endoscopic injection (NASHA/Dx gel).

Main Results:

  • Endoscopic injection with NASHA/Dx gel demonstrates an excellent safety profile.
  • Success rates for NASHA/Dx gel injection approach those of open ureteral reimplantation.
  • Endoscopic injection presents fewer disadvantages compared to open surgery or antibiotic prophylaxis.

Conclusions:

  • Endoscopic injection, particularly with NASHA/Dx gel, is a highly recommended first-line treatment for VUR.
  • A short course of antibiotics may precede endoscopic injection therapy.
  • This minimally invasive approach offers a favorable alternative for managing pediatric VUR.

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