Longterm outcome of Macroplatique injection for treatment of vesicoureteral reflux in children.

Abstract

BACKGROUND:

This study examined our experience with one year follow-up of 20 cases of vesicoureteric reflux in children after treatment with Macroplastique ® injection.

PATIENT AND METHODS:

A total of 20 children (31 ureters) with primary grades II to V vesicoureteral reflux were treated with subureteral Macroplastique ® injection from 2010 to 2011 and followed for an average of 12 months (range 3 to 24). Vesicoureteral reflux was grade II in 3, III in 7, IV in 9 and V in 12 ureters. Each child underwent pre-operative voiding cystourethrography, abdominopelvic ultrasound, urine analysis/culture, S. creatinine and CBC. Dimercapto-succinic acid scan (DMSA scan) and magnetic resonance urography (MRU) were done in some patients. Voiding cystourethrography at 3 months was done to rule out persistent reflux.

RESULTS:

Overall, reflux was corrected in 11 (35.5%) ureters and 9 (45%) children after a single injection. With repeat injection, reflux was corrected in 16 (51.6%) ureters and 11 (55%) children, reflux improved/downgrade in 4 (12.9%) ureters and 2 (10%) children. Correction by grade was 100%, 100%, 9.7%, 9.7% for grades II to V, respectively. There were no surgical complications. None of the cured patients had recurrent reflux during follow-up. There were 9 (45%) children who required open ureteral re-implantation for failed injection.

CONCLUSION:

Sub-ureteral Macroplastique ® injection therapy could be a primary treatment for low grade VUR (grade III or less) in children because it is simple, safe, effective, less invasive, decreased.

• Authors: Elrahmany A Mohamed, Farghal H Shehata, Elemam A Abdelbaset, Mohamed A Abdelkhalek, Ashraf H Abdelatif, Husain A Galal
• Journal: African journal of paediatric surgery : AJPS (Afr J Paediatr Surg) 2014 Apr-Jun Vol. 11 Issue 2 Pg. 174-8 ISSN: 0974-5998 [Electronic] India
• PMID: 24841022 (Publication Type: Journal Article)

Chemical References

• Dimethylpolysiloxanes
• baysilon

Topics

• Child
• Child, Preschool
• Cohort Studies
• Developing Countries
• Dimethylpolysiloxanes (therapeutic use)
• Dose-Response Relationship, Drug
• Drug Administration Schedule
• Egypt
• Female
• Follow-Up Studies
• Humans
• Infant
• Injections, Intralesional
• Male
• Retrospective Studies
• Risk Assessment
• Severity of Illness Index
• Time
• Treatment Outcome
• Urography (methods)
• Vesico-Ureteral Reflux (diagnostic imaging, drug therapy)