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

Pediatric Surgery International
Manuela HunzikerPrem Puri

Abstract

Since DX/HA was approved by the Food and Drug Administration in 2001 as an acceptable tissue-augmenting substance for subureteral injection, endoscopic treatment has become increasingly popular for treating vesicoureteral reflux (VUR). However, most paediatric urologists still continue to recommend ureteral reimplantation as the treatment of choice in the management of grade V VUR. The purpose of this study was to prospectively evaluate the effectiveness of endoscopic subureteral injection of DX/HA in the treatment of grade V reflux. During 2001-2009, 56 children (35 males, 21 females) with primary grade V VUR underwent endoscopic treatment using DX/HA. Their ages ranged from 4 months to 11 years. Forty-nine patients had unilateral grade V VUR, and seven had bilateral grade V (63 refluxing ureters including 17 duplex systems). Renal scarring on dimercaptosuccinic acid was observed in 39 kidneys (mild scarring 13, moderate scarring 14 and severe scarring 12). In all patients, endoscopic injection was made after inserting the needle within the wide ureteral orifice. Renal ultrasound and voiding cystourethrogram was performed 3 months after the endoscopic treatment. If VUR had not resolved, the patient was considered for further e...Continue Reading

References

Jul 4, 2001·The Journal of Urology·K OganH G Rushton
Jan 17, 2003·The New England Journal of Medicine·Alejandro HobermanEllen R Wald
Apr 8, 2006·The Journal of Urology·Jonathan C RouthYuri Reinberg

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Citations

Sep 20, 2012·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Girolamo MattioliGian Marco Ghiggeri
Jan 10, 2014·Journal of Endourology·Rosa M RomeroAna Rosa Tardáguila
Sep 21, 2017·Journal of Pediatric Surgery·Ling LeungKenneth Kak Yuen Wong

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