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Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up

INTRODUCTION: The endoscopic correction of vesicoureteral reflux (VUR) in children is a currently well accepted therapy in many pediatric urology centers. Polyacrylate-polyalcohol copolymer (PPC), namely Vantris(®), is one of the tissue-augmenting substances used for endoscopic reflux therapy. The a...

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Autores principales: Warchoł, Stanisław, Krzemień, Grażyna, Szmigielska, Agnieszka, Bombiński, Przemysław, Toth, Krzysztof, Dudek-Warchoł, Teresa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Polish Urological Association 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656363/
https://www.ncbi.nlm.nih.gov/pubmed/29104797
http://dx.doi.org/10.5173/ceju.2017.1226
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author Warchoł, Stanisław
Krzemień, Grażyna
Szmigielska, Agnieszka
Bombiński, Przemysław
Toth, Krzysztof
Dudek-Warchoł, Teresa
author_facet Warchoł, Stanisław
Krzemień, Grażyna
Szmigielska, Agnieszka
Bombiński, Przemysław
Toth, Krzysztof
Dudek-Warchoł, Teresa
author_sort Warchoł, Stanisław
collection PubMed
description INTRODUCTION: The endoscopic correction of vesicoureteral reflux (VUR) in children is a currently well accepted therapy in many pediatric urology centers. Polyacrylate-polyalcohol copolymer (PPC), namely Vantris(®), is one of the tissue-augmenting substances used for endoscopic reflux therapy. The aim of this study was to evaluate the results with PPC in children. MATERIAL AND METHODS: From 2012 to 2016, 125 children (73 girls and 52 boys) aged 0.6–17.9 years (mean 4.9 ±3.58) were treated with PPC. VUR was unilateral in 64 and bilateral in 61 patients, comprising 197 renal refluxing units (RRUs) grades: II in 72, III in 50, IV in 33 and V in 42. Of these primary reflux was present in 132 RRUs and 65 were complex cases. Voiding cystourethrogram (VCUG) was done 3 months after procedure. RESULTS: Follow-up was completed in 89.6% of patients (112 children), and 89.8% of RRUs (177 out of 197). Reflux resolved in 86.4% of RRUs after single injection, in 99.4% after second and in 100% after the third. The only significant, but serious complication observed was late ureteral obstruction after PPC injection correcting high grade reflux, which required ureteral re-implantation. This complication was found in 9 out of 112 children (8%), and in 11 out of 177 RRUs (6.2%), 1.1 -2.9 years (mean 2 ±0.7) after the PPC injection. The longest follow-up reaches 4.5 years. CONCLUSIONS: Our data show that the PPC injection is an effective procedure for treating all grades of VUR with high success rate. However, because of the possibility of late ureteral obstruction, which requires ureteroneocystostomy, long-term follow-up is mandatory.
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spelling pubmed-56563632017-11-03 Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up Warchoł, Stanisław Krzemień, Grażyna Szmigielska, Agnieszka Bombiński, Przemysław Toth, Krzysztof Dudek-Warchoł, Teresa Cent European J Urol Original Paper INTRODUCTION: The endoscopic correction of vesicoureteral reflux (VUR) in children is a currently well accepted therapy in many pediatric urology centers. Polyacrylate-polyalcohol copolymer (PPC), namely Vantris(®), is one of the tissue-augmenting substances used for endoscopic reflux therapy. The aim of this study was to evaluate the results with PPC in children. MATERIAL AND METHODS: From 2012 to 2016, 125 children (73 girls and 52 boys) aged 0.6–17.9 years (mean 4.9 ±3.58) were treated with PPC. VUR was unilateral in 64 and bilateral in 61 patients, comprising 197 renal refluxing units (RRUs) grades: II in 72, III in 50, IV in 33 and V in 42. Of these primary reflux was present in 132 RRUs and 65 were complex cases. Voiding cystourethrogram (VCUG) was done 3 months after procedure. RESULTS: Follow-up was completed in 89.6% of patients (112 children), and 89.8% of RRUs (177 out of 197). Reflux resolved in 86.4% of RRUs after single injection, in 99.4% after second and in 100% after the third. The only significant, but serious complication observed was late ureteral obstruction after PPC injection correcting high grade reflux, which required ureteral re-implantation. This complication was found in 9 out of 112 children (8%), and in 11 out of 177 RRUs (6.2%), 1.1 -2.9 years (mean 2 ±0.7) after the PPC injection. The longest follow-up reaches 4.5 years. CONCLUSIONS: Our data show that the PPC injection is an effective procedure for treating all grades of VUR with high success rate. However, because of the possibility of late ureteral obstruction, which requires ureteroneocystostomy, long-term follow-up is mandatory. Polish Urological Association 2017-07-24 2017 /pmc/articles/PMC5656363/ /pubmed/29104797 http://dx.doi.org/10.5173/ceju.2017.1226 Text en Copyright by Polish Urological Association http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Warchoł, Stanisław
Krzemień, Grażyna
Szmigielska, Agnieszka
Bombiński, Przemysław
Toth, Krzysztof
Dudek-Warchoł, Teresa
Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up
title Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up
title_full Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up
title_fullStr Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up
title_full_unstemmed Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up
title_short Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up
title_sort endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (vantris): 5-years of prospective follow-up
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656363/
https://www.ncbi.nlm.nih.gov/pubmed/29104797
http://dx.doi.org/10.5173/ceju.2017.1226
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