The role of intraoperative cystography following the injection of dextranomer/hyaluronic acid copolymer

The Journal of Urology
Lane S Palmer

Abstract

Dextranomer/hyaluronic acid copolymer has become a popular bulking agent for subureteral injection in the treatment of vesicoureteral reflux. The success rates are lower compared to ureteral reimplantation, and, therefore, postoperative voiding cystourethrography is required. We sought to determine if post-injection intraoperative cystography can be useful in improving the success rate of injection and replacing the need for the 3 to 4-month postoperative voiding cystourethrogram. Dextranomer/hyaluronic acid copolymer was injected subureterally by a single surgeon until the orifice was crescentic at the dome of the bolus. Contrast material was instilled by gravity into the bladder until capacity was reached and was monitored fluoroscopically. No voiding phase was obtained. The procedure was deemed successful only in the absence of reflux. Postoperative voiding cystourethrography performed at 3 to 4 months postoperatively was used to determine whether antibiotic administration should be discontinued. The results of the 2 cystograms were compared. A total of 41 patients (64 ureters) underwent subureteral injection. Intraoperative post-injection cystogram documented reflux eradication after a single injection in 96.9% of ureters a...Continue Reading

References

Nov 1, 1988·The Journal of Urology·B O'Donnell, P Puri
Jul 1, 1996·The Journal of Urology·D M HoenigA A Caldamone
Sep 1, 1997·The Journal of Urology·M D BomalaskiD A Bloom
Jan 15, 2000·Scandinavian Journal of Urology and Nephrology·A StenbergG Läckgren

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Citations

Aug 7, 2008·Advances in Urology·Jennifer A HagertyEarl Y Cheng
Nov 13, 2010·BJU International·Alana M MurphyTerry W Hensle

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