Endoscopic Management of Vesicoureteral Reflux and Long-term Follow-up
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To report our experience with endoscopic management of vesicoureteral reflux (VUR) by injection of a tissue bulking substance–Dextranomer/ hyaluronic acid copolymer at vesicoureteric junction.
Retrospective analyses of case records.
Pediatric Surgery department in a tertiary care government Institute.
500 children (767 renal units) consecutively referred to the out-patient department with vesicoureteral reflux noted on micturating cysto-urethrogram (MCU) over a period of 13 years (2004-2016).
Preoperative VUR grading and renal scars on radionuclide scans were documented. Dextranomer hyaluronic acid copolymer was injected through a cystoscope at the vesicoureteral junction as a day care procedure under short anesthesia. Patients were followed (average duration 27.3 mo) with clinical assessment, periodic urine cultures and renal scans.
Main outcome measure
Cessation of VUR and symptomatic relief / clinical success postoperatively at 3 months.
Complete symptomatic relief was obtained in 482 (96.4%) patients. In 681 units where MCU was available, 614 (90%) units showed resolution of VUR.
Endoscopic injection of tissue bulking substances at vesicoureteric junction to stop VUR seems to be an effective intervention
KeywordsDextranomer Renal scars Urinary tract infection
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