Early Results of Endoscopic Treatment of Vesicoureteral Reflux with Polyacrylate Polyalcohol Copolymer

Objective: To evaluate the early results of endoscopic treatment of vesicoureteral reflux (VUR) in children using polyacrylate polyalcohol copolymer (PPC). Patients and Methods: We retrospectively reviewed 45 patients treated with subureteric injection of PPC in our clinic. The results of voiding cystouretrography performed on the 3rd postoperative month and the results of 1-year follow-up were evaluated. Results: A total of 45 patients (57 ureters) underwent injection of PPC. The mean age of the patients was 6.5 years. There were 6 (10.5%) grade 1, 7 (12.2%) grade 2, 26 (45.6%) grade 3, 16 (28%) grade 4, and 2 (3.5%) grade 5 VUR. There were 11 overactive bladders, 2 duplex collecting systems, and 4 posterior urethral valves among the patients. Voiding cystouretrography postoperatively at the 3rd month showed that VUR had disappeared in 82.5% (47/57) of the ureters, downgraded to grade 2 and 3 in 7% (4/57), persisted in 5.2% (3/57) and upgraded in 5.2% (3/57). The success rate at the end of the first year was 98.1%. The procedure was free of complications such as fever, dysuria, lumbar pain or obstruction in all patients. No patient showed VUR recurrence at the end of the first year. Conclusions: The short-term results of our patients suggested that PPC can be safely and successfully used in the endoscopic treatment of VUR in children. However, further prospective, controlled trials showing the long-term results of the patients are needed.

[1]  H. Mazdak,et al.  Postoperative ureteral obstruction after endoscopic treatment of vesicoureteral reflux with polyacrylate polyalcohol copolymer (Vantris®). , 2013, Journal of pediatric urology.

[2]  B. Chertin,et al.  Preliminary data on endoscopic treatment of vesicoureteric reflux with polyacrylate polyalcohol copolymer (Vantris®): surgical outcome following single injection. , 2011, Journal of pediatric urology.

[3]  F. Dénes,et al.  New tissue bulking agent (polyacrylate polyalcohol) for treating vesicoureteral reflux: preliminary results in children. , 2010, The Journal of urology.

[4]  R. Alasino,et al.  Vantris, a biocompatible, synthetic, non-biodegradable, easy-to-inject bulking substance. Evaluation of local tissular reaction, localized migration and long-distance migration. , 2008, Archivos espanoles de urologia.

[5]  M. Levasseur,et al.  Endoscopic treatment of vesicoureteric reflux with Deflux: a Canadian experience. , 2012, Canadian Urological Association journal = Journal de l'Association des urologues du Canada.

[6]  J. Pope,et al.  Endoscopic therapy for vesicoureteral reflux: a meta-analysis. I. Reflux resolution and urinary tract infection. , 2006, The Journal of urology.

[7]  P. Caione,et al.  The role of endoscopic treatment of vesicoureteral reflux: a 17-year experience. , 2004, The Journal of urology.

[8]  Y. Chavrier,et al.  [Vesicoureteric reflux in children: long-term results of endoscopic treatment by Macroplastique injection]. , 2004, Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie.

[9]  P. Puri,et al.  Treatment of vesicoureteric reflux by endoscopic injection of Teflon. , 1984, The Journal of urology.

[10]  E. T. Simpson,et al.  Direct comparison of radiology and nuclear medicine cystograms in young infants with vesico‐ureteric reflux , 2001, BJU international.

[11]  H. Gerner,et al.  Long-term efficacy of subureteral collagen injection for endoscopic treatment of vesicoureteral reflux in neurogenic bladder cases. , 2000, The Journal of urology.

[12]  P. Mckenna,et al.  Results of a vesicoureteral reflux practice pattern survey among American Academy of Pediatrics, Section on Pediatric Urology members. , 1998, The Journal of urology.

[13]  V. Hasselblad,et al.  Pediatric Vesicoureteral Reflux Guidelines Panel summary report on the management of primary vesicoureteral reflux in children. , 1997, The Journal of urology.

[14]  M. Leonard,et al.  Endoscopic treatment of vesicoureteral reflux with collagen: preliminary report and cost analysis. , 1996, The Journal of urology.

[15]  W. Greene,et al.  Endoscopic treatment of reflux: migration of Teflon to the lungs and brain. , 1993, European urology.

[16]  S. Barham,et al.  Migration and granulomatous reaction after periurethral injection of polytef (Teflon). , 1984, JAMA.

[17]  E. Matouschek.  [Treatment of vesicorenal reflux by transurethral teflon-injection (author's transl)]. , 1981, Der Urologe. Ausg. A.

[18]  Medical versus surgical treatment of primary vesicoureteral reflux: a prospective international reflux study in children. , 1981, The Journal of urology.