scholarly journals An all-endo Approach to Complete Ureteral Duplications Complicated by Ureterocele and/or Vesicoureteral Reflux: Feasibility, Limitations, and Results

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
A. Calisti ◽  
M. L. Perrotta ◽  
R. Coletta ◽  
C. Olivieri ◽  
V. Briganti ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Vesicoureteral Reflux ◽  
Therapeutic Option ◽  
Endoscopic Management ◽  
Attractive Alternative ◽  
Consecutive Series ◽  
Secondary Surgery ◽  
Acid Copolymer ◽  
Effective Therapeutic Option ◽  
Main Complication

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.

Endoscopic Injection of Dextranomer/Hyaluronic Acid Copolymer to Correct Vesicoureteral Reflux Following Failed Ureteroneocystostomy

2006 ◽  
Vol 176 (4S) ◽  
pp. 1861-1863 ◽  
Author(s):  
David Kitchens ◽  
Eugene Minevich ◽  
William DeFoor ◽  
Pramod Reddy ◽  
Jeffrey Wacksman ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Vesicoureteral Reflux ◽  
Endoscopic Injection ◽  
Acid Copolymer

Injection volumes of dextranomer/hyaluronic acid are increasing in the endoscopic management of vesicoureteral reflux

2010 ◽  
Vol 26 (5) ◽  
pp. 509-513 ◽  
Author(s):  
Mathew D. Sorensen ◽  
Martin A. Koyle ◽  
Charles A. Cowan ◽  
Ismael Zamilpa ◽  
Margarett Shnorhavorian ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Vesicoureteral Reflux ◽  
Endoscopic Management

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

2010 ◽  
Vol 26 (10) ◽  
pp. 977-979 ◽  
Author(s):  
Manuela Hunziker ◽  
Nochiparambil Mohanan ◽  
Federica D’Asta ◽  
Prem Puri
Keyword(s):  
Hyaluronic Acid ◽  
Vesicoureteral Reflux ◽  
Endoscopic Treatment ◽  
Primary Grade ◽  
Acid Copolymer

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

2008 ◽  
Vol 2008 ◽  
pp. 1-7 ◽  
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.

scholarly journals Subureteral Injection with Small-Size Dextranomer/Hyaluronic Acid Copolymer: Is It Really Efficient?

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Iyimser Üre ◽  
Serhat Gürocak ◽  
Özgür Tan ◽  
Amirali Farahvash ◽  
Cem Senol ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Success Rate ◽  
Vesicoureteral Reflux ◽  
Low Cost ◽  
Clinical Results ◽  
Voiding Cystourethrogram ◽  
Complication Rates ◽  
Success Rates ◽  
Acid Copolymer ◽  
Urinary Infections

The aim of this study was to evaluate the clinical results of patients with vesicoureteral reflux, which were treated with subureteral injection of small-size (80–120 μm) dextranomer/hyaluronic acid copolymer (Dx/HA). Data of 75 children (105 renal units) who underwent STING procedure with small-size Dx/HA for the treatment of vesicoureteral reflux (VUR) in our clinic between 2008 and 2012 were retrospectively analyzed. Preoperative reflux grade and side, injection indication, postoperative urinary infections and urinary symptoms, voiding cystourethrogram, and renal scintigraphy results were evaluated. The success rate of the procedure was 100% in patients with grades 1 and 2 reflux, 91% in patients with grade 3 reflux, and 82.6% in patients with grade 4. Overall success rate of the treated patients was 97%. Endoscopic subureteric injection with Dx/HA procedure has become a reasonable minimally invasive alternative technique to open surgery, long-term antibiotic prophylaxis, and surveillance modalities in treatment of VUR in terms of easy application, low costs and complication rates, and high success rates. Injection material composed of small-size dextranomer microspheres seems superior to normal size Dx/HA, together with offering similar success with low cost.

scholarly journals The “incidental anesthetic” — an opportunity for the endoscopic correction of vesicoureteral reflux in children

2013 ◽  
Vol 3 (3) ◽  
pp. 225
Author(s):  
Elena Tamarkina ◽  
Mohammed El-Sherbiny ◽  
Roman Jednak ◽  
John-Paul Capolicchio
Keyword(s):  
Vesicoureteral Reflux ◽  
Prise En Charge ◽  
Endoscopic Management ◽  
First Line Therapy ◽  
Acid Copolymer ◽  
Line Therapy ◽  
Endoscopic Correction ◽  
The Cost ◽  
Acide Hyaluronique

Introduction: The endoscopic management of vesicoureteral reflux(VUR) with subureteric injection (STING) has become more popular.The low morbidity associated with the STING procedure hasled to some authors advocating its use as a first-line therapy. Manyparents are uncomfortable with this procedure being performedin children because of the potential morbidity associated with generalanesthesia. We present an alternative without added anestheticmorbidity: offering the parents a STING when their childis undergoing an anesthetic for another surgical indication.Methods: We reviewed the records of 10 children who underwentincidental dextranomer/hyaluronic acid copolymer (DHA) injectionover a 2-year period.Results: We considered the treatment outcome after a single STINGprocedure to be successful in 8 (80%) patients and a failure in 2(20%). Distribution of VUR grade, according to the highest gradeper patient, was high in 5 (50%) patients, moderate in 3 (30%)and low in 2 (20%). We observed no complications.Conclusion: The idea of performing STING in children under incidentalanesthetic introduces yet another possibility in the paradigmof VUR care. Though the long-term efficacy of DHA remains to bedetermined, this option reduces the potential morbidity of DHA asfirst-line therapy while favourably altering the cost benefit.Introduction : L'injection sub-urétérale endoscopique est uneméthode de plus en plus utilisée pour la prise en charge d'un refluxvésico-urétéral (RVU). La faible morbidité associée à cette techniquea amené certains auteurs à recommander son emploi entraitement de première ligne. Bien des parents ne sont pas à l'aiseavec cette suggestion en raison du risque de morbidité lié àl'anesthésie générale. Nous présentons ici une solution de rechangequi n'augmente pas la morbidité liée à l'anesthésie, soit le recoursà l'injection sub-urétérale endoscopique pendant que l'enfantest déjà sous anesthésie pour une autre intervention chirurgicale.Méthodes : Les dossiers de 10 enfants ayant subi une injectionde copolymère de dextranomère / acide hyaluronique (DxAH) aucours d'une période de 2 ans ont été passés en revue.Résultats : Après une seule injection sub-urétérale, l'issue du traitement a été jugée excellente chez 8 patients (80 %) et un écheca été constaté chez 2 patients (20 %). La distribution des stadesde RVU en fonction du stade le plus élevé noté chez chaque patientétait la suivante : grade élevé, 50 %, modéré, 30 % et faible, 20 %.Aucune complication n'a été observée.Conclusion : L'idée de recourir à une injection sub-urétérale pendantune autre intervention nécessitant une anesthésie ajoute uneoption dans l'algorithme de traitement du RVU. Même si l'efficacitéà long terme du DxAH reste à établir, cette option a l'avantagede réduire le risque de morbidité lié au DxAH comme traitementde première ligne tout en modifiant pour le mieux l'équationcoûts-avantages.

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