Intra-orifice versus hydrodistention implantation technique in dextranomer/hyaluronic acid injection for vesicoureteral reflux

The Journal of Urology
Amit Gupta, Warren Snodgrass

Abstract

Original implantation procedures used dextranomer/hyaluronic acid to create a volcano-like mound at the orifice. Subsequently the hydrodistention implantation technique was described to coapt the intramural ureteral wall with less emphasis on achieving a mound at the orifice and it was reported to be associated with improved outcomes. We compared the results of intra-orifice injection to establish a mound vs the hydrodistention implantation technique. Univariate and multivariate logistic regression analysis was used to compare results in 96 ureters undergoing intra-orifice injection vs 52 undergoing the hydrodistention implantation technique. We evaluated patient gender and age, reflux grade, injection technique, injected volume and the number of injection sites. Successful reflux resolution was achieved in 124 ureters (84%) with a single implantation, including 83 (86.5%) with intra-orifice injection and 41 (79%) with HIT (p = 0.23). Mean injected volume was significantly increased for the hydrodistention implantation technique vs intra-orifice injection (0.68 vs 0.51 cc, p = 0.002). Univariate analysis showed that female gender, older age, reflux grade and number of injection sites were associated with success. On multivariat...Continue Reading

References

Aug 1, 1975·The Journal of Urology·G G Mackie, F D Stephens
Jan 16, 2007·The Journal of Urology·James Higham-KesslerAnthony A Caldamone

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Citations

Jun 23, 2011·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Jennifer Sung, Steven Skoog
Jun 19, 2013·Journal of Pediatric Urology·Sean T WattersSteven J Skoog
Mar 30, 2012·The New England Journal of Medicine·David A Diamond, Tej K Mattoo
Aug 1, 2009·Therapeutic Advances in Urology·Göran Läckgren, Arne Stenberg
Apr 11, 2019·Frontiers in Pediatrics·Aylin N Bilgutay, Andrew J Kirsch
Jun 15, 2017·Investigative and Clinical Urology·Sang Woon KimSang Won Han
Sep 21, 2017·Journal of Pediatric Surgery·Ling LeungKenneth Kak Yuen Wong

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