Single injection results of endoscopic treatment of vesicoureteric reflux with different tissue-bulking substances in patients with end stage renal failure.

Abstract

PURPOSE:

To evaluate the outcome of subureteral injections by using calcium hydroxyapatite (CaHa), dextranomer/hyaluronic acid copolymer (Dx/HA), and polydimethylsiloxane (PDS) in patients with end-stage renal failure (ESRF) who have vesicoureteral reflux (VUR).

PATIENTS AND METHODS:

One hundred-one patients (166 renal units) with ESRF secondary to VUR were included in this retrospective study. The reflux was bilateral in 65 of the cases. CaHa, Dx/HA and PDS were used in 57, 26, and 18 patients, respectively. All patients were reviewed with regard to age, sex, reflux grade, type of injected materials, injectable agent volume, and outcome.

RESULTS:

The reflux resolved completely in 30 patients (50/96 renal units, 52.1%), in 17 patients (27/44 renal units, 61.4%), and in 4 patients (5/26 renal units, 19.2%) with CaHa, Dx/HA, and PDS, respectively. Regression rates of reflux to grade I with these agents in the same order were 3.1% (2 patients, 3/96 renal units), 4.5% (1 patient, 2/44 renal units), and 11.5% (2 patients, 3/26 renal units). Thus, the overall success rate were noted as 55.2%, 65.9%, and 30.7%, respectively. There was no difference among these three injectables with regard to overall success rates (P = 0.062). No significant correlation with age, reflux grade, agent volume, and significant difference with sex were observed (P > 0.05).

CONCLUSIONS:

In this group of patients, the success rate of the subureteral injection treatment does not appear to be affected by the type of the injectable agent. In addition, the cure rates were independent from the individual factors, reflux grades, and injected volumes.

• Authors: Ayhan Dirim, Eray Hasirci, Tahsin Turunc, Cem Aygun, Hakan Ozkardes
• Journal: Journal of endourology (J Endourol) Vol. 25 Issue 5 Pg. 831-5 (May 2011) ISSN: 1557-900X [Electronic] United States
• PMID: 21476901 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Dextrans
• Dimethylpolysiloxanes
• dextranomer-hyaluronic acid copolymer
• baysilon
• Hyaluronic Acid
• Durapatite

Topics

• Adolescent
• Adult
• Child
• Dextrans (administration & dosage, therapeutic use)
• Dimethylpolysiloxanes (administration & dosage, therapeutic use)
• Durapatite (administration & dosage, therapeutic use)
• Endoscopy
• Female
• Humans
• Hyaluronic Acid (administration & dosage, therapeutic use)
• Injections
• Kidney Failure, Chronic (complications, drug therapy)
• Male
• Middle Aged
• Treatment Outcome
• Vesico-Ureteral Reflux (complications, drug therapy)
• Young Adult