Bladder ultrasound in the evaluation of the efficacy of dextranomer/hyaluronic acid injection for treatment of vesicoureteral reflux

Özcan, Coşkun; Ergün, Raziye; Özbek, Süha Süreyya; Avanoğlu, Ali; Ulman, brahim

doi:10.1002/jcu.20359

Cited by 14 publications

(9 citation statements)

References 13 publications

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“…The same authors also estimated a positive predictive value (PPV) of 89% for the presence of mound on ultrasound imaging and prediction of VUR resolution at VCUG. Similar results were obtained by Ozcan et al [10] who suggested a PPV of 86.3% based on 19 of 22 ureters with an identifiable mound that had no VUR on VCUG.…”

Section: Discussionsupporting

confidence: 89%

“…Unfortunately, VCUG remains a distressing and uncomfortable investigation for children and their parents, graved by concern for radiation exposure, particularly in children who should undergo long term followup examinations. Recently some authors identified ultrasound mound appearance as a potential predictor of success of the procedure [8][9][10]. Moreover many technical variables could play a role in determining successful outcome, such as ureteral hydrodistention, bladder filling, and height of the obtained mound.…”

mentioning

confidence: 99%

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Intraoperative ultrasound-assisted approach for endoscopic treatment of vesicoureteral reflux in children

Zambaiti

Sergio

Casuccio

et al. 2017

Journal of Pediatric Surgery

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Intraoperative ultrasound-assisted approach for endoscopic treatment of vesicoureteral reflux in children

Zambaiti

Sergio

Casuccio

et al. 2017

Journal of Pediatric Surgery

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“…3). The examination was performed as described in published study by Özcan et al [16] All descriptive data are shown as means and standard deviation (SD), median or numbers (%). Performance characteristics were calculated as follows: sensitivity = (true positive)/(true positive + false negative); speci city = (true negative)/(true negative + false positive); positive predictive value (PPV) = (true positive)/(true positive + false positive); negative predictive value (NPV) = (true negative)/(false negative + true negative); accuracy = (true positive + true negative)/(true positive + false negative + true negative + false positive).…”

Section: Methodsmentioning

confidence: 99%

Efficacy of Bladder Ultrasound in Prediction of Resolution of Vesicoureteral Reflux after Endoscopic Subureteral Hyaluronic Acid/Dextranome (Deflux®) Injection

Aboutaleb¹,

Eldib²,

Omar³

et al. 2021

Preprint

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BACKGROUND: We evaluated the efficacy of bladder ultrasound to predict resolution of vesicoureteral reflux after subureteral endoscopic Hyaluronic acid/dextranome (Deflux) injection.METHODS: Between 2010 and 2018, 120 patients (220 ureters) underwent Subureteral Deflux injection for reflux in children. Male/female ratio was 1: 5. All patients had voiding cystourethrography and bladder ultrasound at 3 months and one year after surgery. Outcome analysis included: Success rates and presence/ absence of Deflux mount by bladder ultrasound. RESULTS: Mean follow-up was 48 months. Mean age at surgery 72 months. Grades of reflux were grade II in 100 ureters (45.4%), III in 90 ureters (41%) and IV-V in 30 ureters (13.6%). Bilateral surgery was performed in 40 patients. Single Deflux injection cured reflux (Success rate) in 85% (187 ureters) at 3 months which improved to 88.2% (194 ureters) at last follow-up. Ultrasound was able to detect Deflux mounts at the base of the bladder in 200 ureters (91%). Sensitivity and specificity of ultrasound was 92.68% and 20% of the correction of reflux at the last follow up. Positive Predictive Value of bladder ultrasound was 94 % and accuracy was 87.7 % at the last follow up. Ultrasound did not detect the mount in 20 ureters (9 %) and 8 of these ureters (3.6%) had persistence of their reflux. Ultrasound was able to detect bilateral mounts as well as unilateral mounts.CONCLUSION: Bladder-US was highly sensitive for detection of Deflux implants and can predict resolution of reflux in 82.7% of refluxing ureters. Postoperative bladder-US could be adjusted as a screening tool in the follow-up of patients with primary low-grade VUR patients treated by Deflux injection, while VCUG could be preserved for follow-up of high-grade VUR patients.

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“…They also noticed that the febrile UTI rate was significantly higher in children on surveillance (57%) than on prophylaxis (19%) and endoscopic therapy (23%). Ozcan et al [17] reported on a 2D bladder ultrasound in the evaluation of the efficacy of Dx/HA injection for VUR treatment. The success rate of endoscopic reflux correction in this series was 88%.…”

Section: Discussionmentioning

confidence: 99%

“…These digitalized images facilitate comparisons within the follow-up measurements. There are a couple of studies concerning ultrasound examination in the follow-up of endoscopic therapy [7][8][9][10][11][12][13][14][15][16][17] . Sonography is noninvasive, without radiation burden and significant data are even available in incompliant children.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Treatment of Vesicoureteral Reflux Using Dextranomer/Hyaluronic Acid Copolymer in Children: Results of Postoperative Follow-Up with Real-Time 3D Sonography

Pichler

Buttazzoni²,

Bektic

et al. 2011

Urol Int

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Objectives: We evaluated whether real-time 3D ultrasound (4D-US) together with clinical evaluation is an alternative to voiding cystourethrography (VCUG) after endoscopic treatment of vesicoureteral reflux (VUR) in children at postoperative follow-up. Material and Methods: We reviewed 178 children who underwent endoscopic therapy with dextranomer/hyaluronic acid copolymer in grade II or III VUR between 2002 and 2005. 4D-US was performed in all patients 1 day and 3, 9 and 18 months after endoscopic therapy. Only children with postoperative urinary tract infections (UTIs) and/or nonorthotopic position of the bulking agent were referred for VCUG. Results: In 93% of the ureteral units, the depot could be detected in the orthotopic position after 3, 9 and 18 months. None of these children developed UTIs in the postoperative follow-up. Twelve children demonstrated a shifting of the depot, indicating a possible therapy failure. Eight of these 12 patients (66.7%) presented a positive VCUG, and 50% of them sustained UTIs. Conclusions: 4D-US seems to be a sufficient protocol in the follow-up of children after endoscopic treatment of low-grade VUR. VCUG should be performed in cases of a shifted position of the depot; invasive investigations are unnecessary in asymptomatic children with orthotopic bulk.

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Bladder ultrasound in the evaluation of the efficacy of dextranomer/hyaluronic acid injection for treatment of vesicoureteral reflux

Cited by 14 publications

References 13 publications

Intraoperative ultrasound-assisted approach for endoscopic treatment of vesicoureteral reflux in children

Intraoperative ultrasound-assisted approach for endoscopic treatment of vesicoureteral reflux in children

Efficacy of Bladder Ultrasound in Prediction of Resolution of Vesicoureteral Reflux after Endoscopic Subureteral Hyaluronic Acid/Dextranome (Deflux®) Injection

Endoscopic Treatment of Vesicoureteral Reflux Using Dextranomer/Hyaluronic Acid Copolymer in Children: Results of Postoperative Follow-Up with Real-Time 3D Sonography

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