Abstract | PURPOSE: MATERIALS AND METHODS: A total of 320 children 3 to 11 years old with grade II to IV vesicoureteral reflux confirmed by voiding cystourethrography underwent endoscopic treatment with dextranomer/hyaluronic acid copolymer. Of the patients 50 were re-treated with dextranomer/hyaluronic acid copolymer because of persistent reflux (grade II or greater). The first implantation technique was recorded on videotape. Voiding cystourethrography and micturition details were recorded at the 3 to 6-month followup visit and compared with baseline measurements. RESULTS: At baseline 13 patients had known voiding dysfunction and 18 were misdiagnosed as not having voiding dysfunction. Of the 50 patients who required re-treatment, the initial implant was correctly positioned in 45 according to the videotape. Endoscopic observation at the time of re-treatment revealed no evidence of the implant in 15 patients. The implant was displaced in 27 patients and remained correctly positioned in 3. A total of 27 patients had voiding dysfunction, the majority of whom had urgency and frequency incontinence, had not received any anticholinergic therapy and had a displaced implant. CONCLUSIONS: Uncontrolled voiding dysfunction contributed to endoscopic treatment failure with dextranomer/hyaluronic acid copolymer in our series. Therefore, we suggest that patients with voiding dysfunction be treated at least 6 months before endoscopic therapy with anticholinergics and/or micturition rehabilitation.
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Authors | Nicola Capozza, Alberto Lais, Ennio Matarazzo, Simona Nappo, Mario Patricolo, Paolo Caione |
Journal | The Journal of urology
(J Urol)
Vol. 168
Issue 4 Pt 2
Pg. 1695-8
(Oct 2002)
ISSN: 0022-5347 [Print] United States |
PMID | 12352337
(Publication Type: Journal Article)
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Chemical References |
- Dextrans
- deflux
- Hyaluronic Acid
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Topics |
- Child
- Child, Preschool
- Cystoscopy
- Dextrans
- Female
- Humans
- Hyaluronic Acid
- Male
- Outcome and Process Assessment, Health Care
- Postoperative Complications
(diagnostic imaging, surgery)
- Prosthesis Failure
- Prosthesis Implantation
- Reoperation
- Urinary Incontinence
(diagnostic imaging, surgery)
- Urodynamics
- Urography
- Vesico-Ureteral Reflux
(diagnostic imaging, surgery)
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