A systematic review &amp; meta-analysis comparing outcomes of endoscopic treatment of primary vesico ureteric reflux in children with polyacrylate poly alcohol copolymer versus dextranomer hyaluranic acid

Babu, Ramesh; Chandrasekharam, V.V.S.

doi:10.1016/j.jpedsurg.2022.01.025

Cited by 8 publications

(4 citation statements)

References 26 publications

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Section: Resultsmentioning

confidence: 99%

“…When assessing the clinical relevancy, post-injection febrile UTI rate between PPC (12%) and Dx/HA (14.6%) was not statistically significant ( p = 0.54) [ 53 ]. The volume of bulking agent used for the injection was higher in case of Dx/HA rather than PPC [ 53 ]. A recent systematic review and meta-analysis indicated that PPC injection was associated with higher success rate, but concerningly, ureterovesical junction obstruction (UVJO) incidence was higher in the PPC group which might negate the possible benefits of PPC injection [ 54 ].…”

Section: Resultsmentioning

confidence: 99%

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Endoscopic injection of bulking agents in pediatric vesicoureteral reflux: a narrative review of the literature

et al. 2023

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In the last 20 years, endoscopic injection (EI) has affirmed as a valid alternative to open surgery for management of pediatric vesicoureteral reflux (VUR). This study aimed to investigate and discuss some debated aspects such as indications, bulking agents and comparison, techniques of injection and comparison, predictive factors of success, use in specific situations. EI is minimally invasive, well accepted by patients and families, with short learning curve and low-morbidity profile. It provides reflux resolution rates approaching those of open reimplantation, ranging from 69 to 100%. Obviously, the success rate may be influenced by several factors. Recently, it is adopted as first-line therapy also in high grade reflux or complex anatomy such as duplex, bladder diverticula, ectopic ureters. The two most used materials for injection are Deflux and Vantris. The first is absorbable, easier to inject, has lower risk of obstruction, but can lose efficacy over time. The second is non-absorbable, more difficult to inject, has higher risk of obstruction, but it is potentially more durable. The two main techniques are STING and HIT. To date, the ideal material and technique of injection has not yet clearly established, but the choice remains dependent on surgeon’s preference and experience.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Endoscopic injection of bulking agents in pediatric vesicoureteral reflux: a narrative review of the literature

et al. 2023

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“…Many studies in the literature compare the effects of different methods and different materials on re ux resolution rates after endoscopic injections. [8][9][10][11] In a meta-analysis, renal unit-based evaluation showed that the re ux resolution rate after STING was 75.7%. [8] In other words, patients who have undergone STING will either have repeated STING requirements or require ureteroneocystostomy despite recurrent STING.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Reflux Persistence After Endoscopic Dextranomer/Hyaluronic Acid Copolymer Injection for the First Time in Pediatric Patients with Vesicoureteral Reflux: Short-term Results

Yilmaz,

Akdogan,

Deger

et al. 2023

Preprint

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This study aims to investigate the factors effective in predicting the persistence of reflux after the first subureteric transurethral injection (STING) of dextranomer/hyaluronic acid copolymer in pediatric patients with vesicoureteral reflux. The data of patients without a previous history of surgery to treat vesicoureteral reflux and who underwent STING for the first time between September 2011 and November 2020 were investigated retrospectively. After considering exclusion criteria, of 199 patients, 127 patients and 180 renal unit were suitable for inclusion. A renal unit-based evaluation was made. Age < 61 months (univariate: p = 0.001, multivariate: p = 0.015, HR: 2.352 (1.181–4.686), OR (95% CI)), moderate reflux level (grade 3) (univariate: p < 0.001, multivariate: p = 0.019, HR: 2.703 (1.177–6.209), OR (95% CI)), DRF (differential renal function) < 45 (univariate: p = 0.020, multivariate: p = 0.047, HR: 1.992 (1.009–3.935), OR (95% CI)), and UDR (ureteral diameter ratio) > 0.15 (univariate: p < 0.001, multivariate: p = 0.005, HR: 2.786 (1.368–5.672), OR (95% CI)) were found to be factors that negatively affected reflux resolution after STING surgery. In our study, UDR and DRF were found to be factors affecting reflux persistence. UDR and DRF should be considered in order to predict reflux resolution in patients who will undergo STING.

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“…Ultrasound [ Figure 1 ] and computed tomography scan [ Figure 2 ] demonstrated a radio-opaque lesion at the left vesicoureteric junction region. [ 1 2 ] Cystoscopy and ureteroscopy were normal. Awareness of late calcification following endoscopic treatment is essential.…”

mentioning

confidence: 99%

Late Calcification Following Endoscopic Treatment of Reflux Masquerading as a Distal Ureteric Calculus

Prasad,

Babu

2023

Journal of Indian Association of Pediatric Surgeons

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A systematic review & meta-analysis comparing outcomes of endoscopic treatment of primary vesico ureteric reflux in children with polyacrylate poly alcohol copolymer versus dextranomer hyaluranic acid

Cited by 8 publications

References 26 publications

Endoscopic injection of bulking agents in pediatric vesicoureteral reflux: a narrative review of the literature

Endoscopic injection of bulking agents in pediatric vesicoureteral reflux: a narrative review of the literature

Predictors of Reflux Persistence After Endoscopic Dextranomer/Hyaluronic Acid Copolymer Injection for the First Time in Pediatric Patients with Vesicoureteral Reflux: Short-term Results

Late Calcification Following Endoscopic Treatment of Reflux Masquerading as a Distal Ureteric Calculus

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