Overall Outcomes and Factors Predicting the Success of Endoscopic Dextranomer/Hyaluronic Acid Copolymer Injection for Vesicoureteral Reflux

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.

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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

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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

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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.

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

BioMed Research International ◽

10.1155/2016/2168753 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 3

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.

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