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Endoscopic Management of Vesicoureteral Reflux and Long-term Follow-up

K Ln Rao1, Prema Menon2, R Samujh1

  • 1Department of Pediatric Surgery, PGIMER, Chandigarh, India.

Indian Pediatrics
|February 13, 2019
PubMed

Insights

Endoscopic injection of dextranomer/hyaluronic acid copolymer effectively treated vesicoureteral reflux (VUR) in children. This minimally invasive procedure provided significant symptomatic relief and VUR resolution in most patients.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Urologic Oncology

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children, increasing the risk of urinary tract infections and renal scarring.
  • Traditional surgical treatments for VUR can be invasive, carrying potential risks and longer recovery times.
  • Endoscopic management offers a less invasive alternative for VUR treatment.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of endoscopic management of VUR using dextranomer/hyaluronic acid copolymer injection.
  • To assess the success rates of this minimally invasive technique in resolving VUR and providing symptomatic relief in pediatric patients.

Main Methods:

  • Retrospective analysis of 500 children (767 renal units) with VUR treated between 2004 and 2016.
  • Dextranomer/hyaluronic acid copolymer injected endoscopically at the vesicoureteric junction as a day care procedure.
  • Follow-up included clinical assessment, urine cultures, and renal scans to assess VUR resolution and symptomatic improvement.

Main Results:

  • Complete symptomatic relief achieved in 96.4% of patients.
  • Successful resolution of VUR confirmed by micturating cysto-urethrogram in 90% of treated renal units.
  • Average follow-up duration of 27.3 months demonstrated sustained effectiveness.

Conclusions:

  • Endoscopic injection of dextranomer/hyaluronic acid copolymer is an effective intervention for managing VUR in children.
  • This minimally invasive approach offers a high success rate for VUR resolution and symptomatic improvement.
  • The procedure is suitable for day care management, providing a favorable treatment option for pediatric VUR.
Abstract

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