Skip to main content
SpringerLink
Log in
Book cover

Interventional Management of Urological Diseases pp 89–101Cite as

Endoscopic Treatment of Vesicoureteral Reflux

  • Chapter

  • 472 Accesses

Part of the book series: Recent Advances in Endourology ((ENDOUROLOGY,volume 8))

Summary

Since its introduction in 1984, endoscopic treatment of vesicoureteral reflux (VUR) has gained popularity and has proved successful in an increasing number of patients. Continuous improvements in injectable materials and increased experience with the technique have led to a broadening of the indications for endoscopic treatment.The authors report their experience with 1732 patients and 2455 refluxing ureters, treated over the past 20 years. From January 1986 to June 2005, 1732 patients underwent endoscopic treatment for grades II to V VUR. Polytetrafluoroethylene was injected as the bulking material in the first 14 cases; after 1989 bovine collagen was used in 442 cases, and starting in 1995 dextranomer/hyaluronic acid copolymer was used in 1276 cases.The followup protocol also changed over the years.The main changes consisted of time and number of micturition cystourethrograms (MCUG): in the first years MCUG was performed 3 and 12 months after endoscopic treatment; after 1999 a single MCUG was performed 3–6 months postoperatively. Minimum follow-up was 6 months.After one injection the overall success rate was 79% of ureters, and 91%, 78%, and 62% for grades II, III, and IV-V VUR, respectively. After the second injection, the overall success rate increased to 91%. Voiding dysfunction was identified as a possible limiting factor in the success of endoscopic treatment. Our results confirm that endoscopic treatment of VUR is a valid alternative to both long-term antibiotic prophylaxis and open surgery. The short hospital stay, the absence of significant postoperative complications, the safety of new injectable materials, and the increasingly high success rate suggest that endoscopic treatment should be offered as a first-line option to all children with VUR.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Report of the International Reflux Study in Children (1981) Medical versus surgical treatment of primary vesicoureteral reflux: report of the International Reflux Study Committee. Pediatrics 67:392

    Google Scholar 

  2. Capozza N, Lais A, Nappo S, Caione P (2004) The role of endoscopic treatment of vesicoureteral reflux: a 17-year experience. J Urol 172:1626–1629

    Article  PubMed  Google Scholar 

  3. Matousceck E (1981) Die bahandlung des vesikorenalen refluxes durch transurethrale einspritzung von Teflon paste. Urologe A 20:263–264

    Google Scholar 

  4. Puri P, O’Donnell B (1984) Correction of experimentally produced vesicoureteric reflux in the piglet by intravesical injection of Teflon. Br Med J 289:5–7

    CAS  Google Scholar 

  5. O’Donnell B, Puri P (1984) Treatment of vesicoureteric reflux by endoscopic injection of Teflon. Br Med J 289:7–9

    CAS  Google Scholar 

  6. Capozza N, Caione P, Nappo S, De Gennaro M, Patricolo M (1995) Endoscopic treatment of vesico-ureteric reflux and urinary incontinence; technical problems in the pediatric patients. Br J Urol 75:538–563

    Article  PubMed  CAS  Google Scholar 

  7. Kirsch AJ, Perez-Brayfield MR, Smith EA (2004) The modified STING procedure to correct vesicoureteral reflux: improved results with submucosal implantation within the intramural ureter. J Urol 171(1):2413–2416

    Article  PubMed  Google Scholar 

  8. Mittleman RE, Maraccini JV (1983) Pulmonary Teflon granulomas following periurethral Teflon injection for urinary incontinence. Arch Pathol Lab Med 107:611–612

    PubMed  CAS  Google Scholar 

  9. Malizia AA, Reiman HM, Myers RP, Sande JR, Barham SS, Benson RC (1984) Migration and granulomatous reaction after periurethral injection of polytef (Teflon). JAMA 251:3277–3281

    Article  PubMed  Google Scholar 

  10. Rames RA, Aaronson IA (1991) Migration of polytef paste to the lung and brain following intravesical injection for the correction of reflux. Pediatr Surg Int 6:239–240

    Article  Google Scholar 

  11. Vandenbossche M, Delhove O, Dumortier P, Deneft F, Schulman CC (1993) Endoscopic treatment of reflux; experimental study and review of Teflon and collagen. Eur Urol 23:386–393

    PubMed  CAS  Google Scholar 

  12. Miyakita H, Puri P (1994) Particles found in lung and brain following subureteral injection of polytetrafluoroethylene paste are not Teflon particles. J Urol 152:636–640

    PubMed  CAS  Google Scholar 

  13. Peters CA, Jeffs RD (1987) Endoscopic correction of primary vesicoureteric reflux with bovine collagen injected submucosally at the ureteral orifice. J Urol 137(2):122A (abstract 76)

    Google Scholar 

  14. Cendron M, Leonard MP, Gearhart JP, Jeffs RD (1991) Endoscopic treatment of vesicoureteral reflux using cross-linked bovine dermal collagen. Pediatr Surg Int 6:295–300

    Article  Google Scholar 

  15. Frey P, Jenny P, Herzog B (1991) Endoscopic subureteric collagen injection (SCIN): a new alternative treatment of vesicoureteric reflux in children. Experience in 82 refluxing ureters. Pediatr Surg Int 6:287–294

    Google Scholar 

  16. Frey P, Berger D, Jenny P, Herzog B (1992) Subureteral collagen injection for the endoscopic treatment of vesicoureteral reflux in children. Follow-up study of 97 treated ureters and histological analysis of collagen implants. J Urol 148:718–723

    PubMed  CAS  Google Scholar 

  17. Ellingsworth LR, De Lustro F, Brennan JE, Sawamura S, McPherson J (1986) The human response to reconstituted bovine collagen. J Immunol 136:877–882

    PubMed  CAS  Google Scholar 

  18. Cukier J, Beauchamp RA, Spindler JS, Sindler S, Lorenzo C, Trentham DE (1993) Association between bovine collagen dermal implants and dermatomyosistis or polymiositis-like syndrome. Ann Intern Med 118:920–928

    PubMed  CAS  Google Scholar 

  19. Preston Smith D, Kaplan WE, Ryoichi O (1994) Evaluation of polymethylsiloxane as an alternative in the endoscopic treatment of vesicoureteral reflux. J Urol 152:1221–1223

    Google Scholar 

  20. Henley DR, Barrett DM, Weiland TL, O’Connor MK, Malizia AA, Wein AJ (1995) Particulate silicone for use in periurethral injections: local tissue effects and search for migration. J Urol 153:2039–2043

    Article  Google Scholar 

  21. Atala A, Kim W, Paige KT, Vacanti CA, Retik AB (1994) Endoscopic treatment of vesicoureteral reflux with a chondrocyte-alginate suspension. J Urol 152(2):641–643

    Google Scholar 

  22. Caldamone AA, Diamond DA (2001) Long-term results of the endoscopic correction of vesicoureteral reflux in children using autologous chondrocytes. J Urol 165(2):2224–2227

    Google Scholar 

  23. Mayer R, Chertin B, Velayudham M, Laxaman D, Colhoun E (2001) Preliminary evaluation of calcium hydroxylapatite as a transurethral bulking agent for stress urinary incontinence. Urology 57:434–438

    Article  PubMed  CAS  Google Scholar 

  24. Mevorach R, Rabinowitz R, Beck C, Hulbert W (2002) Endoscopic treatment of vesicoureteral reflux with Coaptite: the first 50 patients. J Urol 167:429 (abstract)

    Google Scholar 

  25. Stendberg A, Lackgren G (1995) A new bioimplant Deflux System for the endoscopic treatment for vesicoureteral reflux. Experimental and clinical results. J Urol 154:800–803

    Article  Google Scholar 

  26. Stendberg AM, Sundin A, Laarson E, Lackgren G, Stendberg A (1997) Lack of distant migration after injection of 25 iodine-labelled dextranomer based implant into rabbit bladder. J Urol 158:1937–1941

    Article  Google Scholar 

  27. Elder JS, Diaz M, Caldamone AA (2004) Endoscopic therapy for vesicoureteral reflux. A meta-analysis. Presented at American Academy of Pediatrics 2004 National Conference and Exhibition, San Francisco, CA, October 10, 2004

    Google Scholar 

  28. Capozza N, Caione P (2002) Dextranomer/hyaluronic acid copolymer implantation for vesicoureteral reflux: a randomized comparison with antibiotic prophylaxis. J Pediatr 140(2):230–234

    Google Scholar 

  29. Lackgren G, Stendberg A, Wahlin N (2001) Long-term follow-up of children treated with dextranomer/hyaluronic acid copolymer for vesicoureteral reflux. J Urol 166(5):1887–1892

    Article  PubMed  CAS  Google Scholar 

  30. Yucel S, Ucar M, Guntekin E, Kukul E, Melikoglu M, Baykara M (2005) The effect of location of the ureteric orifice on the efficacy of endoscopic injection to correct vesico-ureteric reflux. BJU Int 95(9):1314–1318

    Article  PubMed  Google Scholar 

  31. Capozza N, Lais A, Matarazzo E, Nappo S, Patricolo M, Caione P (2002) Influence of voiding dysfunction on the outcome of endoscopic treatment for vesicoureteral reflux. J Urol 168:1695–1698

    Article  PubMed  CAS  Google Scholar 

  32. Elder JS (1997) Pediatric vesicoureteral reflux guidelines panel summary: report on the management of primary vesicoureteral reflux in children. J Urol 157(5):1846–1851

    Google Scholar 

  33. Ditchfield MR, De Campo JF, Nolan TM (1994) Risk factors in the development of early renal cortical defects in children with urinary tract infection. Am J Roentgenol 162:1393–1397

    CAS  Google Scholar 

  34. Winberg J (1992) Progressive renal damage from infection with or without reflux. J Urol 148:1733–1734

    PubMed  CAS  Google Scholar 

  35. Birmingham Reflux Study Group (1987) Prospective trial of operative versus nonoperative treatment of severe vesicoureteric reflux in children: five years observation. Br Med J 295:237–241

    Google Scholar 

  36. Smellie JM, Poulton A, Prescod N (1994) Retrospective study of children with renal scarring associated with reflux and urinary tract infection. Br Med J 308:1193–1196

    CAS  Google Scholar 

  37. Shimada K, Matsui T, Ogino T (1988) Renal growth and progression of reflux nephropathy in children with vesicoureteral reflux. J Urol 140:1097–1100

    PubMed  CAS  Google Scholar 

  38. Nasseer SR, Steinhardt GF (1997) New renal scars in children with urinary tract infections, vesicoureteral reflux and voiding dysfunction: a prospective evaluation. J Urol 158:566–568

    Article  Google Scholar 

  39. Cooper CS, Chung BI, Kirsch AJ (2000) The outcome of stopping prophylactic antibiotics in older children with vesicoureteral reflux. J Urol 163:269–273

    Article  PubMed  CAS  Google Scholar 

  40. Thompson RH, Chen JJ, Pugatch J (2001) Cessation of prophylactic antibiotics for managing persistent vesicoureteral reflux. J Urol 166:1465–1469

    Article  PubMed  CAS  Google Scholar 

  41. Smellie JM, Jodal U, Mobius TT, Hirche H, Olbing H (2001) Outcome at 10 years of severe vesicoureteric reflux managed medically: report of the International Reflux Study in children. J Pediatr139(5):656–663

    Google Scholar 

  42. Bollgren I (1999) Antibacterial prophylaxis in children with urinary tract infection. Acta Paediatr Suppl 88(431):48–52

    Article  Google Scholar 

  43. Ogan K, Pohl HG, Carlson D, Belman AB, Rushton HG (2001) Parental preferences in the management of vesicoureteral reflux. J Urol 166:240–243

    Article  PubMed  CAS  Google Scholar 

  44. Capozza N, Lais A, Matarazzo E (2003) Treatment of vesicoureteral reflux: a new algorithm based on parental preference. BJU Int 92(3):285–288

    Article  Google Scholar 

  45. Kobelt G, Canning DA, Hensle TW (2003) The cost effectiveness of endoscopic injection of dextranomer/hyaluronic acid copolymer for vesicoureteral reflux. J Urol 169:1480–1485

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatric Urology, “Bambino Gesù” Children’s Hospital, Piazza S. Onofrio, 4, Rome, 00165, Italy

    Nicola Capozza & Daniela Zavaglia

Authors
  1. Nicola Capozza
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Daniela Zavaglia
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Urology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa, 228-8555, Japan

    Shiro Baba M.D., Ph.D. (Professor and Chairman) (Professor and Chairman)

  2. Department of Urology, Nagoya University School of Medicine, 65 Tsurumai, Showa-ku, Nagoya 466-8550, Japan

    Yoshinari Ono M.D., Ph.D. (Associate Professor) (Associate Professor)

Rights and permissions

Reprints and permissions

Copyright information

© 2006 The Japanese Society of Endourology and ESWL

About this chapter

Cite this chapter

Capozza, N., Zavaglia, D. (2006). Endoscopic Treatment of Vesicoureteral Reflux. In: Baba, S., Ono, Y. (eds) Interventional Management of Urological Diseases. Recent Advances in Endourology, vol 8. Springer, Tokyo. https://doi.org/10.1007/978-4-431-35642-4_6

Download citation

  • DOI: https://doi.org/10.1007/978-4-431-35642-4_6

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-35641-7

  • Online ISBN: 978-4-431-35642-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation