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J Pediatr Urol. 2014 Dec;10(6):1032-6. doi: 10.1016/j.jpurol.2014.02.016. Epub 2014 Apr 5.

Endoscopic correction of primary VUR by using polyacrylate polyalcohol copolymer (Vantris) in young girls: 2-year follow-up.

Author information

1
Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Islamic Republic of Iran. Electronic address: fsharifiaghdas@yahoo.com.
2
Shahid Labbafinejad Medical Center, Urology and Nephrology Research Center, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Islamic Republic of Iran.
3
Iran University of Medical Sciences, Tehran, Islamic Republic of Iran.

Abstract

OBJECTIVE:

Our aim was to evaluate the efficacy and safety of single endoscopic injection of Vantris in young girls affected by primary vesicoureteral reflux (VUR) at more than 2 years of prospective follow-up.

MATERIAL AND METHODS:

Over the last 4 years, 73 girls with primary VUR of grades (G) I-IV underwent a single endoscopic injection of Vantris. The mean age was 8.48 (SD=4.8) years. VUR was unilateral in 73 and bilateral in 13 patients, comprising 86 renal refluxing units (RRUs). Pre-operative evaluation consisted of: blood biochemistry, urine analysis and culture, ultrasound scan, voiding cystourethrogram (VCUG), and dimercaptosuccinic acid (DMSA) renal isotope scan. Patients were followed using ultrasound scans at 1 month and every 3 months for the first year and then 2 years after injection. Direct radionuclide cystography with technetium pertechnetate was performed at 3 and 12 months after injection. VCUG was performed only in confirmed cases of failure and downgraded VUR at 3, 12, and 24 months after endoscopic correction.

RESULTS:

Sixty-nine (95%), 61 (83.4%), and 52 (71%) patients completed 3, 12, and 24 months' follow-up respectively. VUR was corrected and downgraded to G I in 81% and 3.3% of RRUs at 3 months' follow-up. The corrected and downgraded RRUs at 12 and 24 months' follow-up were 77%, 10%, and 77%, 11% respectively. De novo contralateral G I VUR was demonstrated in 8.6% of normal ureters. Contralateral GI VUR with normal DMSA isotope renal scans was resolved in 71% of RRUs. Febrile urinary tract infection decreased to 4.1% in the patients.

CONCLUSION:

According to our study, a single Vantris injection provides a high level of efficacy and safety in the treatment of primary G I-IV VUR in young girls, at 2 years' prospective follow-up.

KEYWORDS:

Endoscopy; Subureteric injection; Vantris; Vesicoureteral reflux

PMID:
24953543
DOI:
10.1016/j.jpurol.2014.02.016
[Indexed for MEDLINE]
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