Long-term efficacy of subureteral collagen injection for endoscopic treatment of vesicoureteral reflux in neurogenic bladder cases.

Abstract

PURPOSE:

We evaluated the long-term efficacy of subureteral glutaraldehyde cross-linked collagen injection (GAX 35) for endoscopic treatment of vesicoureteral reflux in patients with neurogenic bladder dysfunction due to meningomyelocele.

MATERIALS AND METHODS:

We prospectively studied 12 women and 8 men (26 ureteral renal units) with a median age of 8 years (range 1 to 51) who had neurogenic bladder due to meningomyelocele. Reflux into single collecting systems was treated with subureteral collagen injection (GAX 35). Followup with video urodynamics included voiding cystography.

RESULTS:

All patients performed intermittent catheterization to control the bladder. During the study all bladders were areflexic with normal compliance. Preoperative reflux according to the International Reflux Study Classification was grade I in 1, II in 9, III in 10, IV in 4 and V in 2 ureteral renal units. All patients were treated with subureteral collagen injection (mean volume 1.9 ml., range 0.7 to 3.5). Reflux resolved initially in all but 2 cases. Mean followup was 16 months (range 1 to 71). Reflux was still absent in only 15% of treated units after 24 months.

CONCLUSIONS:

Our data suggest that endoscopic subureteral collagen injection in neurogenic bladder cases is not effective with long-term followup. New biocompatible and biodegradable materials should be tested to control vesicoureteral reflux.

• Authors: A Haferkamp, K Möhring, G Staehler, H J Gerner, J Dörsam
• Journal: The Journal of urology (J Urol) Vol. 163 Issue 1 Pg. 274-7 (Jan 2000) ISSN: 0022-5347 [Print] United States
• PMID: 10604375 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Collagen

Topics

• Adolescent
• Adult
• Child
• Child, Preschool
• Collagen (administration & dosage)
• Female
• Humans
• Infant
• Injections
• Male
• Middle Aged
• Prospective Studies
• Time Factors
• Ureteroscopy
• Urinary Bladder, Neurogenic (complications, physiopathology)
• Urodynamics
• Vesico-Ureteral Reflux (etiology, physiopathology, prevention & control)