scholarly journals SUBURETERAL MUCOSA INJECTION WITH DETRANOMER/HYALURONIC ACID FOR VESICOURETERAL REFLUX TREATMENT: SYSTEMATIC REVIEW

2017 ◽  
Vol 24 (1) ◽  
Author(s):  
Nicholas Tambunan ◽  
Arry Rodjani ◽  
Irfan Wahyudi
Keyword(s):  
Hyaluronic Acid ◽  
Success Rate ◽  
Vesicoureteral Reflux ◽  
Random Effects Model ◽  
Success Rates ◽  
Statistical Software ◽  
Hyaluronic Acid Injection ◽  
Grade 5 ◽  
Meta Regression ◽  
It Success

Objective: The aim of this study is to search the success rate of detranomer-hyaluronic acid (Dx/HA) used as injection through endoscopy approach and grades of vesicoureteral reflux (VUR) that could affect it success rate. Material & methods: We searched the literatures from MEDLINE database and PubMed from year 2001 until 2013. The data was analyzed using Random Effects Model with the method of Mantzel-Haenzel to analyze the success rates of dextranomer/hyaluronic acid and was determined by 95% Confidence of Interval (CI) disclosure. Meta-regression was performed to adjust the success rate compared with the grade of VUR as covariate. We assessed the heterogeneity by calculating the I2 statistic. All analyses were performed with Stata Statistical Software Version 12.0 (StataCorp). Results: We identified 9 literatures in full review. Of 1105 ureters that were injected with dextranomer/hyaluronic acid, 817 (72%; CI: 67-76%) were successfully treated according to author’s definition. The success rates of Dx/HA for pediatric with grade 1 VUR reached 80% (95% CI: 66-89%), whereas in grade 5 VUR only 50% (95% CI: 34-66%; p<0.05). Conclusion: The overall success rate of dextranomer/hyaluronic acid injection treatment was 72% after 3 months, although success rates varied widely among studies. Preoperative grade of VUR was significantly associated with treatment outcome. Increased VUR grade negatively affected success rates.

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 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.

Bladder ultrasound in the evaluation of the efficacy of dextranomer/hyaluronic acid injection for treatment of vesicoureteral reflux

2007 ◽  
Vol 35 (7) ◽  
pp. 357-362 ◽  
Author(s):  
Coşkun Özcan ◽  
Raziye Ergün ◽  
Süha Süreyya Özbek ◽  
Ali Avanoğlu ◽  
⋖brahim Ulman
Keyword(s):  
Hyaluronic Acid ◽  
Vesicoureteral Reflux ◽  
Hyaluronic Acid Injection ◽  
Acid Injection

scholarly journals A Comparison of Calcium Hydroxyapatite and Dextranomer/Hyaluronic Acid for the Endoscopic Treatment of Vesicoureteral Reflux

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Tin C. Ngo ◽  
Ilene Yi-Zhen Wong ◽  
William A. Kennedy
Keyword(s):  
Hyaluronic Acid ◽  
Learning Curve ◽  
Success Rate ◽  
Endoscopic Treatment ◽  
Single Injection ◽  
Statistical Significance ◽  
Case Series ◽  
Calcium Hydroxyapatite ◽  
Success Rates ◽  
Single User

Purpose. Minimal data exists comparing dextranomer/hyaluronic acid (Dx/HA) and calcium hydroxyapatite (CaHA) for the endoscopic treatment of VUR in the hands of a single user.Materials and Methods. We reviewed our consecutive single-user case series of 27 children (42 ureters) receiving endoscopic treatment with CaHA and 21 children (33 ureters) who received Dx/HA injection. Children receiving CaHA injections were divided into two groups of 13 and 14 patients (Coaptite I and II) to assess the learning curve effects. Postoperatively, RBUS and VCUG were performed. Multiple regression analysis was performed to assess statistical significance of success rates.Results. The total CaHA group had a per-ureter success rate (Grade 0) of 52% after one injection. When separated into two cohorts, the single injection per-ureter success rates were 43% for Coaptite I and 62% for Coaptite II. In contrast, the Dx/HA series had a single injection per-ureter success rate (Grade 0) of 78%.Conclusions. Our consecutive case experience shows improved results for Dx/HA compared to CaHA, though the learning curve effects and evolution of injection technique likely played a role in the improved outcomes in the Dx/HA cohort. A randomized controlled multicenter trial would provide the most accurate data comparing these two agents.

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