Learning From the Learning Curve: Factors Associated With Successful Endoscopic Correction of Vesicoureteral Reflux Using Dextranomer/Hyaluronic Acid Copolymer

Purpose. Totally endoscopic management (all-endo) of patients with a duplicated renal system (DS) associated with severe vesicoureteral reflux (VUR) or obstructive ureterocele (UC) is an attractive alternative to traditional open procedures. The authors discuss feasibility and results of an all-endo approach on a consecutive series of patients.Methods. From 1999 to 2009, all patients with a complete DS associated with UC and/or VUR were proposed for primary all-endo approach. UC puncture was performed using a 3 Fr Bugbee electrode. Deflux (dextranomer/hyaluronic acid copolymer) injection was administered for VUR. The need for secondary surgery was evaluated on followup.Results. Of the 62 patients recruited, 46 were treated using a primary all-endo approach and 16 patients received no treatment. Of the 46 treated patients with 56 affected renal units, 32 (97%) UCs collapsed following puncture and 29 (63%) VURs were resolved or downgraded. Secondary VUR occurred in 13 (39%) renal units. Secondary surgery was performed on 23 (41%) renal units.Conclusion. The all-endo approach for VUR in DS is an effective therapeutic option. UC collapse was achieved by puncture in most of the patients; secondary VUR was the main complication in a small group of extravesical UC.

Download Full-text

Routine delayed voiding cystourethography after initial successful endoscopic treatment with dextranomer/hyaluronic acid copolymer (Dx/HA) of vesicoureteral reflux (VUR). Is it necessary?

Actas Urológicas Españolas (English Edition) ◽

10.1016/j.acuroe.2016.02.022 ◽

2016 ◽

Vol 40 (10) ◽

pp. 635-639 ◽

Cited By ~ 1

Author(s):

L. García-Aparicio ◽

E. Blázquez-Gómez ◽

A.V. Santandreu ◽

J.A.C. Diaz ◽

J. Vila-Cots ◽

...

Keyword(s):

Hyaluronic Acid ◽

Vesicoureteral Reflux ◽

Endoscopic Treatment ◽

Acid Copolymer

Download Full-text

Endoscopic treatment of primary grade V vesicoureteral reflux using hyaluronic acid copolymer (DX/HA)

Pediatric Surgery International ◽

10.1007/s00383-010-2650-1 ◽

2010 ◽

Vol 26 (10) ◽

pp. 977-979 ◽

Cited By ~ 11

Author(s):

Manuela Hunziker ◽

Nochiparambil Mohanan ◽

Federica D’Asta ◽

Prem Puri

Keyword(s):

Hyaluronic Acid ◽

Vesicoureteral Reflux ◽

Endoscopic Treatment ◽

Primary Grade ◽

Acid Copolymer

Download Full-text

Endoscopic Treatment of Vesicoureteral Reflux with Dextranomer/Hyaluronic Acid in Children

Advances in Urology ◽

10.1155/2008/513854 ◽

2008 ◽

Vol 2008 ◽

pp. 1-7 ◽

Cited By ~ 13

Author(s):

Wolfgang H. Cerwinka ◽

Hal C. Scherz ◽

Andrew J. Kirsch

Keyword(s):

Hyaluronic Acid ◽

Vesicoureteral Reflux ◽

Endoscopic Treatment ◽

Outcome Data ◽

Implantation Technique ◽

Success Rates ◽

Endoscopic Injection ◽

Acid Copolymer ◽

Endoscopic Method ◽

First Choice

Purpose. The goal of this review is to present current indications, injectable agents, techniques, success rates, complications, and potential future applications of endoscopic treatment for vesicoureteral reflux (VUR) in children.Materials and Methods. The endoscopic method currently achieving one of the highest success rates is the double hydrodistention-implantation technique (HIT). This method employs dextranomer/hyaluronic acid copolymer, which has been used in pediatric urology for over 10 years and may be at present the first choice injectable agent due to its safety and efficacy.Results. While most contemporary series report cure rates of greater than 85% for primary VUR, success rates of complicated cases of VUR may be, depending on the case, significantly lower. Endoscopic treatment offers major advantages to patients while avoiding potentially complicated open surgery. As the HIT method continues to be applied to complex cases of VUR and more outcome data become available, the indication for endoscopic treatment may exceed the scope of primary VUR.Conclusions. Endoscopic injection is emerging as the treatment of choice for VUR in children.

Download Full-text