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Published on: January 7, 2019
Endoscopic correction of VUR using vantris as a new non-biodegradable tissue augmenting substance: three years of
Boris Chertin1, Wael Abu Arafeh, Alexander Zeldin
1Department of Pediatric Urology, Hebrew University, Jerusalem, Israel. boris.chertin@gmail.com
Insights
Vantris injection effectively treats pediatric vesicoureteral reflux (VUR), showing high success rates and good outcomes over three years. This minimally invasive treatment offers a promising solution for children with VUR.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Medical Device Technology
Background:
- Vesicoureteral reflux (VUR) affects numerous children, increasing the risk of urinary tract infections (UTIs) and potential kidney damage.
- Endoscopic correction of VUR offers a less invasive alternative to traditional surgery.
- Vantris is a bulking agent used for endoscopic VUR treatment.
Purpose of the Study:
- To assess the long-term efficacy and clinical outcomes of Vantris injection for treating VUR in pediatric patients.
- To evaluate the success rate of Vantris in resolving VUR over a 3-year prospective follow-up period.
Main Methods:
- A prospective study involving 109 children with VUR treated with Vantris via endoscopic injection.
- VUR assessment included ultrasound and voiding cystourethrogram (VCUG) at multiple time points up to 3 years post-procedure.
- Success was defined by VUR resolution, absence of recurrent UTIs, and normal kidney appearance on ultrasound.
Main Results:
- High success rate: 92.7% reflux resolution after one injection, an additional 4.2% after a second.
- No VUR recurrence observed in patients completing 1- and 3-year follow-ups.
- Low incidence of UTIs (3.6% total) and normal kidney ultrasound findings in most patients (98.2%).
Conclusions:
- Vantris injection demonstrates a high success rate for VUR resolution in children.
- The treatment offers a favorable clinical outcome with minimal complications during a 3-year follow-up.
- Vantris is an effective endoscopic treatment option for pediatric VUR.
Objective:
To evaluate the efficacy of Vantris in children with vesicoureteral reflux (VUR) after 3 years of prospective follow-up.
Material And Methods:
Over the last 3 years, 109 children (72 girls and 37 boys) with a mean age of 6.2 ± 3.4 years (mean ± SD) underwent endoscopic correction of reflux using Vantris. VUR was unilateral in 53 and bilateral in 56 patients comprising 165 renal refluxing units (RRUs). Of these, primary VUR was present in 139 RRUs (84.2%) and 26 (15.8%) were complex cases. Ultrasound scan was performed 1 month, 1 year, and 3 years after injection, and voiding cystourethrogram (VCUG) was performed 3 months, 1 year, and 3 years after endoscopic correction.
Results:
The reflux was corrected in 153 RRUs (92.7%) after a single injection and in 7 RRUs (4.2%) after a second injection. In 5 RRUs (3.1%), VUR downgraded to grade I (3 RRUs) and grade II (2 RRUs) and they were taken off antibiotic prophylaxis. Two patients (1.8%) had afebrile urinary tract infections (UTIs) and 2 patients (1.8%) developed febrile UTI. VCUG was performed in 32 of 71 children (39.1%) who completed 1 year and in 6 of 15 (40%) who completed 3 years of follow-up. None showed VUR recurrence. Ultrasound scan demonstrated normal appearance of kidneys in all but 2 patients (1.8%). One patient required stent insertion because of deterioration of hydronephrosis that resulted in complete resolution of obstruction and another patient required ureteral reimplantation.
Conclusion:
Our data show that Vantris injection provides a high level of reflux resolution with good clinical outcome during prospective follow-up.
