Endoscopic treatment with stabilized nonanimal hyaluronic acid/dextranomer gel is effective in vesicoureteral reflux associated with bladder dysfunction.

• Abstract: PURPOSE: Endoscopic injection of stabilized nonanimal hyaluronic acid/dextranomer gel is an established treatment for vesicoureteral reflux in children. We performed a subgroup analysis to assess this treatment in reflux associated with bladder dysfunction. MATERIALS AND METHODS: Of 308 consecutive children treated endoscopically with stabilized nonanimal hyaluronic acid/dextranomer gel for dilating vesicoureteral reflux 54 were observed retrospectively to have bladder dysfunction. Initial followup consisted of voiding cystourethrogram at 3 and 12 months after injection, with positive response defined as reflux grade 0 or I. At 7 to 12 years following treatment patient charts were checked for urinary tract infections and bladder dysfunction, and a followup survey (postal questionnaire) was administered. RESULTS: A positive response to therapy (cure) was observed in 45 children (83%) after 1 to 3 endoscopic treatments. Concurrently, bladder dysfunction had resolved in 32 patients (59%). After the last stabilized nonanimal hyaluronic acid/dextranomer gel implantation 45 patients (83%) were free of urinary tract infections. Questionnaire results were similar to chart based findings. Stabilized nonanimal hyaluronic acid/dextranomer gel implantation was well tolerated, with no associated complications. CONCLUSIONS: Endoscopic treatment with stabilized nonanimal hyaluronic acid/dextranomer gel appears to be similarly effective in patients with vesicoureteral reflux with and without bladder dysfunction. These data indicate that bladder dysfunction should not be considered a contraindication to endoscopic treatment for reflux.
• Authors: Göran Läckgren, Erik Sköldenberg, Arne Stenberg (Affiliation: Section of Urology, University Children's Hospital, Uppsala, Sweden. goran.lackgren at surgsci.uu.se)
• Journal: The Journal of urology (J Urol) Vol. 177 Issue 3 Pg. 1124-8; discussion 1128-9 (Mar 2007) ISSN: 0022-5347 [Print] United States
• PMID: 17296428 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• NASHA-Dx copolymer
• Dextrans
• Hyaluronic Acid

Topics

• Adolescent
• Child
• Child, Preschool
• Dextrans (administration & dosage)
• Endoscopy
• Female
• Follow-Up Studies
• Humans
• Hyaluronic Acid (administration & dosage, analogs & derivatives)
• Male
• Retrospective Studies
• Treatment Outcome
• Urinary Bladder Diseases (complications, therapy)
• Urination Disorders (complications, therapy)
• Vesico-Ureteral Reflux (complications, therapy)