scholarly journals Endoscopic Injection of Bulking Agents for the Treatment of Vesicoureteral Reflux and Introducing a New Material: Acellular Lyophilized Prepuce as a Natural Scaffold

2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Mohammad Javad Mohseni ◽  
Layla Shojaie ◽  
Masoumeh Majidi Zolbin ◽  
Alireza Mohseni ◽  
Hossein Amirzargar ◽  
...  
Keyword(s):  
Vesicoureteral Reflux ◽  
Endoscopic Treatment ◽  
Randomized Clinical Trials ◽  
Inflammatory Responses ◽  
Bulking Agent ◽  
Bulking Agents ◽  
Complication Rates ◽  
Endoscopic Injection ◽  
Acid Copolymer ◽  
Foreign Materials

Context: Endoscopic therapy has been introduced for vesicoureteral reflux (VUR) treatment from the early 1980s and emerged as the first-line treatment in all grades of VUR. Various materials have been used for the endoscopic suburethral application, and their curative role has been characterized by different potential. In this study, we aimed to summarize the global experience with the various bulking agents used for endoscopic treatment of VUR, especially the cure and complication rates, and review our newly introduced bulking agent. Evidence Acquisition: The current literature and our experience on the outcome of endoscopic treatment with different bulking agents were reviewed. Results: Various foreign materials have been used for endoscopic suburethral injections, and their success rate has been different from 40 to ≤ 90 percent. Dextranomer/hyaluronic acid copolymer (Dx/HA), currently the most common bulking agent used for VUR resolution, is an artificial material that helps to grow collagen and fibroblasts. Activation of the immune reaction and the formation of granuloma pseudocysts are impediments after the injection of this agent. Therefore, despite the better consequences in comparison to other agents, the use of this material might be associated with the risk of appearance of serious and persistent complications. Conclusions: Our newly designed decellularized prepuce tissue as a biocompatible tissue-engineered bulking agent, is comparable to Dx/HA regarding low immunoreaction and inflammatory responses with lower price. So, it could be a proper candidate for future randomized clinical trials to investigate the potential of clinical application of the current bulking agent; moreover, it can be an appropriate alternative for Dx/HA.

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 Use of Polyacrylamide Hydrogel for Vesicoureteral Reflux Treatment, a Review

2019 ◽  
Vol 1 (1) ◽  
pp. 2-6
Author(s):  
Francis Lemire ◽  
Anne-Sophie Blais ◽  
Katherine Moore ◽  
Stephane Bolduc
Keyword(s):  
Minimally Invasive ◽  
Vesicoureteral Reflux ◽  
De Novo ◽  
Major Complication ◽  
Infectious Complications ◽  
Bulking Agent ◽  
Bulking Agents ◽  
Polyacrylamide Hydrogel ◽  
Endoscopic Injection ◽  
Significant Difference

Purpose of the review: Vesicoureteral reflux (VUR) is a common pathology encountered in pediatric urology. If left untreated, this condition can lead to infectious complications, hypertension and loss of renal function by scars. There is a trend for minimally invasive procedures to minimise treatment-related complications. Endoscopic subureteral injection of bulking agent in the treatment of VUR is an example of minimally invasive options. Several bulking agents have been studied and the perfect agent has not yet been discovered. Polyacrylamide hydrogel is a relatively new agent used to treat VUR and its use will be reviewed. Recent findings: Three modern studies from a Canadian group have evaluated the use of polyacrylamide hydrogel for endoscopic injection to treat VUR. The first study reported a cure rate of 81.2% without major complication. In the second study, injection of polyacrylamide hydrogel was compared to dextranomer hyaluronic acid and no significant difference was observed, with overall success rate of 73.1% and 77.5% respectively. The third trial evaluated the long-term efficacy and safety of polyacrylamide hydrogel with a 36-month follow-up. Overall success at 3 months was 70.7% and no patient had de novo hydronephrosis or calcification of the agent at 36 months. Conclusion: Polyacrylamide hydrogel seems to be a safe and effective alternative bulking agent in the treatment of VUR. The contribution from other centers to validate those data would be valuable.

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

scholarly journals Surgical Reimplantation for the Correction of Vesicoureteral Reflux following Failed Endoscopic Injection

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Boris Chertin ◽  
Ksenia Prosolovich ◽  
Sagiv Aharon ◽  
Ofer Nativ ◽  
Sarel Halachmi
Keyword(s):  
Success Rate ◽  
Vesicoureteral Reflux ◽  
Endoscopic Treatment ◽  
Endoscopic Procedure ◽  
Ureteral Reimplantation ◽  
Endoscopic Injection ◽  
Stable Function ◽  
Renal Scan

Purpose. In recent years, endoscopic injection became the procedure of choice for the correction of vesicoureteral reflux in the majority of the centers. Unfortunately, endoscopic treatment is not always successful and sometimes requires more than one trial to achieve similar results to that of an open reimplantation surgery. Our aim of this study is to evaluate the feasibility and success rate of open ureteral reimplantation following failed endoscopic procedure.Patients and Methods. During 2004–2010, we evaluated 16 patients with persistent vesicoureteral reflux (grades II–IV) following failed endoscopic treatment. All patients underwent open ureteral reimplantation. All patients were followed with an ultrasound 6 weeks following surgery and every 6 months thereafter for an average of 22 months. Voiding cystography was performed at 3 months after surgery.Results. During unilateral open ureteral reimplantation, the implanted deposit from previous procedures was either excised, drained, or incorporated into the neotunnel with the ureter. Vesicoureteral reflux was resolved in all patients with 100% success rate. No new hydronephrosis or signs of obstruction developed in any of the patients. qDMSA renal scan was available in 8 patients showing improvement of function in 5 and stable function in 3, and no new scars were identified.Conclusions. Open ureteral reimplantation is an excellent choice for the correction of failed endoscopic treatment in children with vesicoureteral reflux.

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
Sign in / Sign up

Export Citation Format

Share Document