Abstract | PURPOSE: Minimally invasive endoscopic treatment for vesicoureteral reflux has become an established alternative to long-term antibiotic prophylaxis and surgical intervention in children. We determined the long-term efficacy and safety of this treatment for high grade reflux in infants. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 411 consecutive infants who underwent endoscopic treatment of grade III to V vesicoureteral reflux between June 1985 and October 2004. A total of 29 patients (7%) were excluded from study because they were lost to followup or the medical records were incomplete. Of the remaining 382 infants, including 203 males, 274 had bilateral and 108 had unilateral vesicoureteral reflux. This represented 642 high grade refluxing units with grade III to V disease in 232, 339 and 71, respectively. A dimercapto- succinic acid scan performed in 312 infants revealed renal scarring in 88 (28%). The tissue augmenting substance used for endoscopic injection was polytetrafluoroethylene and dextranomer/hyaluronic acid copolymer in 432 and 210 ureters, respectively. Endoscopic treatment was done at a median age of 7 months (range 2 months to 1 year). Median followup in these patients was 7 years (range 6 months to 20 years). RESULTS: CONCLUSIONS: Endoscopic correction is a safe, effective, minimally invasive outpatient procedure for high grade vesicoureteral reflux in infants. Early correction of vesicoureteral reflux may provide protection from reflux associated renal damage and prolonged antibiotic use.
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Authors | Michael J Dawrant, Nochiparambil Mohanan, Prem Puri |
Journal | The Journal of urology
(J Urol)
Vol. 176
Issue 4 Pt 2
Pg. 1847-50
(Oct 2006)
ISSN: 0022-5347 [Print] United States |
PMID | 16945670
(Publication Type: Journal Article)
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Chemical References |
- Dextrans
- dextranomer-hyaluronic acid copolymer
- Polytetrafluoroethylene
- Hyaluronic Acid
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Topics |
- Dextrans
(administration & dosage)
- Endoscopy
- Female
- Humans
- Hyaluronic Acid
(administration & dosage)
- Infant
- Injections
- Male
- Polytetrafluoroethylene
(administration & dosage)
- Radioisotope Renography
- Ureter
- Vesico-Ureteral Reflux
(diagnostic imaging, therapy)
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