A comparison of the double hydrodistention implantation technique (HIT) and the HIT with a polyacrylate/polyalcohol copolymer (PPC) for the endoscopic treatment of primary vesicoureteral reflux.

Abstract

OBJECTIVES:

We aimed to compare the success rates of the double hydrodistention implantation technique (HIT) and the HIT with a polyacrylate/polyalcohol copolymer (PPC) for the treatment of primary vesicoureteral reflux (VUR) with a new nonbiodegradable tissue-augmenting substance (Vantris, Promedon, Cordoba, Argentina).

METHODS:

Between January 2011 and December 2012, fifty-two children who underwent subureteric injection for primary VUR are included. The children were randomly separated into two groups, the HIT and the double HIT groups, according to the type of injection. Success was defined as no reflux on a follow-up voiding cystourethrogram (VCUG) after 6 months. The patients were evaluated according to sex, age, grade of reflux, number of injections, and injected volume, and the radiological success rates were compared.

RESULTS:

Fifty-two patients underwent an endoscopic injection for primary grade III-V VUR. The HIT group consisted of 26 patients with 33 ureters, and the double HIT group consisted of 26 patients with 35 ureters. There were no significant differences in terms of the sex, ages, VUR grades, bilaterality between the two groups. The mean injected volumes were ml 1.12 (1.02-1.22) in the HIT group and 1.24 ml (95 % CI 1.10-1.38) in the double HIT group. The reflux was resolved in 21/33 (63.6 %) ureters in the HIT group and in 30/35 (85.7 %) ureters in the double HIT group, (p < 0.05). We had only one complication. This patient in the double HIT group, developed bilateral hydronephrosis and oliguric renal failure requiring open reimplantation at the sixth month.

CONCLUSION:

We observed successful results double HIT method with PPC in Grade III-V reflux, but the long-term follow-up of patients is needed for hydronephrosis. As the double HIT treatment leads to a higher success rate, its use is preferable.

• Authors: Melih Akin, Basak Erginel, Cetin Ali Karadag, Abdullah Yildiz, Gül Sumru Ozçelik, Nihat Sever, Nimetullah Mete Genc, Ali Ihsan Dokucu
• Journal: International urology and nephrology (Int Urol Nephrol) Vol. 46 Issue 11 Pg. 2057-61 (Nov 2014) ISSN: 1573-2584 [Electronic] Netherlands
• PMID: 24966099 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Acrylic Resins
• Biocompatible Materials
• Vantris

Topics

• Acrylic Resins (administration & dosage)
• Biocompatible Materials (administration & dosage)
• Child
• Child, Preschool
• Dissection (methods)
• Female
• Follow-Up Studies
• Humans
• Infant
• Injections
• Male
• Prosthesis Implantation (methods)
• Retrospective Studies
• Treatment Outcome
• Ureter
• Ureteroscopy (methods)
• Vesico-Ureteral Reflux (therapy)