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Endoscopic treatment of vesicoureteral reflux in children with glutaraldehyde cross-linked bovine dermal collagen. Short-term results.

AbstractBACKGROUND:
Endoscopic treatment using glutaraldehyde cross-linked (GAX) collagen was conducted on 4 children with bilateral primary vesicoureteral reflux (VUR)..... a 1-year-old boy and three 5- to 8-year-old girls $B!D (Ball having a history of repeated hospitalization for fever due to acute pyelonephritis, visiting as pediatric outpatients regularly and receiving antibiotics continuously. By international VUR classification, 4 ureters were grade 3, 2 grade 4, and 2 grade 5.
METHODS:
After nonallergy to GAX collagen was confirmed intracutaneously, a needle was used through a 9.5 Fr cystoscope channel to puncture bladder mucosa 4 to 5 mm from the affected ureteral orifice at 6 o'clock under general anesthesia; 1.1 to 1.9 ml of GAX collagen was injected immediately below affected orifices.
RESULTS:
Three months after surgery, voiding cystourethrography showed reflux had disappeared in 6 ureters, for a short-term success rate of 75%. VUR in the Remaining 2 ureters improved from grade 3 to 1 and from grade 5 to 4. No postoperative urinary tract infection occurred and antibiotics were stopped.
CONCLUSION:
Since GAX collagen is less viscous than Teflon paste, it is easily injected into submucosa, does not form granuloma or migrate to other organs, and is noncarcinogenic. Endoscopic VUR treatment using GAX collagen is indicated when less invasion and shorter hospitalization are considered, although it requires general anesthesia, which itself involves some risk.
AuthorsN Tsuboi, K Horiuchi, S Osawa, T Hamasaki, J Yoshida, M Murakami, M Akimoto
JournalJournal of Nippon Medical School = Nippon Ika Daigaku zasshi (J Nippon Med Sch) Vol. 67 Issue 1 Pg. 9-12 (Feb 2000) ISSN: 1345-4676 [Print] Japan
PMID10777841 (Publication Type: Case Reports, Clinical Trial, Journal Article)
Chemical References
  • Collagen
  • Glutaral
Topics
  • Child
  • Child, Preschool
  • Collagen (administration & dosage)
  • Cystoscopy
  • Female
  • Glutaral (pharmacology)
  • Humans
  • Infant
  • Injections
  • Male
  • Pyelonephritis (prevention & control)
  • Treatment Outcome
  • Vesico-Ureteral Reflux (complications, therapy)

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