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Multicenter survey of endoscopic treatment of vesicoureteral reflux using polyacrylate-polyalcohol bulking copolymer (Vantris).

AbstractOBJECTIVE:
To evaluate an outcome of endoscopic correction of vesicoureteral reflux (VUR) using Vantris (Promedon, Cordoba, Argentina) in terms of its effectiveness and morbidity in a multicenter study.
MATERIALS AND METHODS:
From 2009 to 2013, 611 patients (210 boys and 401 girls) with a mean age of 3.56 years (range, 1 month-18 years) were treated at 7 centers worldwide endoscopically with Vantris injection. VUR was unilateral in 413 and bilateral in 198 patients comprising 809 renal refluxing units (RRUs). Of these, primary VUR was present in 674 RRUs (83.3%) and 135 (16.7%) were complex cases. Reflux was grades I-V in 24 (2.96%), 123 (15.2%), 451 (55.8%), 158 (19.5%), and 53 (6.6%) RRUs respectively. The follow-up continued from 6 to 54 months.
RESULTS:
Reflux resolved in 759 RRUs (93.8%) after first Vantris injection, in 26 (3.1%) after second, and in 6 (0.7%) after third injection, respectively. VUR improved to grade I after 1 or 2 injections in 5 ureters (0.6%), which needed no further treatment. Thirteen ureters (1.6%) failed endoscopic correction and required ureteral reimplantation. Vesicoureteral junction obstruction requiring ureteral reimplantation developed in 6 ureters (0.7%) and in 4 (0.5%) required stent insertion. Twenty-three patients (3.8%) suffered afebrile urinary tract infection. Seven (1.2%) developed febrile urinary tract infection. None of the studied patients demonstrated VUR recurrence on voiding cystourethrography.
CONCLUSION:
The results of this multicenter survey confirm that endoscopic subureteral Vantris injection is a simple, safe, and effective outpatient procedure for treating all grades of VUR.
AuthorsStanislav Kocherov, Ibrahim Ulman, Sergey Nikolaev, Juan Pablo Corbetta, Yuriy Rudin, Andjelka Slavkovic, Zafer Dokumcu, Ali Avanoglu, Ludmila Menovshchikova, Semen Kovarskiy, Tatiana Skliarova, Santiago Weller, Juan I Bortagaray, Juan C Lopez, Víctor Durán, Carol Burek, Cristian Sager, Dmitriy Maruhnenko, Tatiana Garmanova, Aliev Djamal, Zorica Jovanovic, Nikola Vacic, Wael Abu Arafeh, Boris Chertin
JournalUrology (Urology) Vol. 84 Issue 3 Pg. 689-93 (Sep 2014) ISSN: 1527-9995 [Electronic] United States
PMID25168553 (Publication Type: Journal Article, Multicenter Study)
CopyrightCopyright © 2014 Elsevier Inc. All rights reserved.
Chemical References
  • Acrylates
  • Acrylic Resins
  • Alcohols
  • Biocompatible Materials
  • Vantris
Topics
  • Acrylates (chemistry)
  • Acrylic Resins (chemistry)
  • Adolescent
  • Alcohols (chemistry)
  • Biocompatible Materials (chemistry)
  • Child
  • Child, Preschool
  • Endoscopy (methods)
  • Female
  • Humans
  • Infant
  • Male
  • Time Factors
  • Ureteroscopy (methods)
  • Urethra (pathology)
  • Urinary Bladder (pathology)
  • Vesico-Ureteral Reflux (therapy)

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