The comparison of dextranomer/hyaluronic acid and polyacrylate-polyalcohol copolymers in endoscopic treatment of vesicoureteral reflux

J Pediatr Surg. 2016 Sep;51(9):1496-500. doi: 10.1016/j.jpedsurg.2016.02.092. Epub 2016 Mar 12.

Abstract

Background: Dextranomer/hyaluronic acid (Dx/Ha;Dexell®) and polyacrylate-polyalcohol copolymer (PPC;Vantris®) are the popular tissue-augmenting substances using for the endoscopic injections of vesicoureteral reflux (VUR). The aim of the study is to evaluate and compare Dx/Ha and PPC in terms of effectiveness, injection techniques and complications with special emphasis on vesicoureteral junction obstruction (VUJO).

Methods: A total of 95 patients who underwent endoscopic VUR treatment between 2009 and 2015 were retrospectively reviewed. The patients were divided into two groups: group 1: Patients underwent endoscopic treatment with PPC (n=50 patients, 70 renal refluxing units) group 2: Patients underwent endoscopic treatment with Dx/Ha (n=45 patients, 74 renal refluxing units).

Results: The overall resolution rates based on the number of renal refluxing units studied was 88.6% and 70.3% in group 1 and group 2, respectively. Resolution rates were significantly better in group 1 compared to group 2. VUJO requiring ureteral reimplantation or stent insertion developed in 7 patients in group 1. No VUJO was observed in group 2. VUJO in group 1 was markedly higher than that in group 2.

Conclusions: Endoscopic treatment of VUR with PPC promises better resolution rates but higher VUJO rates compared to Dx/Ha.

Keywords: Dextranomer; Double HIT; Polyacrylate-polyalcohol; STING; Vesicoureteral reflux.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Acrylic Resins / therapeutic use*
  • Adolescent
  • Child
  • Child, Preschool
  • Dextrans / therapeutic use*
  • Endoscopy*
  • Female
  • Follow-Up Studies
  • Humans
  • Hyaluronic Acid / therapeutic use*
  • Infant
  • Injections
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Vesico-Ureteral Reflux / therapy*

Substances

  • Acrylic Resins
  • Dextrans
  • Vantris
  • dextranomer-hyaluronic acid copolymer
  • Hyaluronic Acid