Endoscopic Correction of Reflux Utilizing Polyacrylate Polyalcohol Bulking Copolymer (Vantris) as a Tissue Augmenting Substance: Lessons Learned Over the 10 Years of Experience

Dothan, David; Kocherov, Stanislav; Jaber, Jawdat; Chertin, Boris

doi:10.1089/lap.2021.0089

Cited by 5 publications

(6 citation statements)

References 23 publications

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“…In most of the studies found in the international literature on endoscopic treatment of VUR, a predominance of the female gender is reported, which coincides with the results of the present investigation 13,14,15,16,17,18,19,20,21 .…”

Section: Discussionsupporting

confidence: 92%

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Risk Factors Associated With Endoscopic Treatment of Vesicoureteral Reflux in Children

Velázquez-Sarabia,

Sarabia-Alcocer,

López-Gutiérrez

et al. 2024

JHS

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Vesicoureteral reflux (VUR) is the abnormal flow of urine backing up from the bladder through the tubes (ureters) that connect the kidneys to the bladder. Normally, urine flows from the kidneys through the ureters to the bladder. It is not supposed to flow in the opposite direction, back to the kidneys. Aim:Identify risk factors associated with endoscopic treatment of VUR in children. Material and methods: A descriptive, retrospective study was carried out on 263 patients with a diagnosis of VUR who received endoscopic treatment, in Health Institutions of the City of San Francisco de Campeche, Campeche, during the period from January 2020 to December 2023. The variables studied were: age, gender, conditions associated with VUR, degree and laterality of reflux, injection technique, complications, severity and treatment of complications. A review of the medical records and files was carried out. The data were processed using SPSS version 23.0. To summarize the variables, absolute and relative frequencies were used; mean and range were determined for age. Results: Females predominated and ages ranged from 5 to 9 years, the average age was 6.12 years. 52.47% of patients presented bilateral VUR. In total, 401 ureteral meatuses were injected, VUR grades III (34.16%) and IV (31.42%) predominated, 11.40% of the sample presented a complete double excretory system. The most used injection technique was the STING (71.10%). 10.26% presented complications, urinary infection was the most frequent (6.46%) followed by late ureteral obstruction (2.28%). Most complications were resolved with medical treatment. Lower grade complications predominated. Conclusions: Endoscopic treatment of VUR is associated with few complications, the most frequent being minor. Late ureteral obstruction is the most serious complication. Long-term followup of patients is important to avoid irreversible kidney damage caused by sustained ureteral obstruction.

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Section: Discussionsupporting

confidence: 92%

“…In relation to the age of patients undergoing endoscopic treatment of VUR, a predominance of mean age that ranges between 3 and 6.7 years is generally observed 11,14,15,16,17,19,20,21 . Results Similar results were obtained in this investigation.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Associated With Endoscopic Treatment of Vesicoureteral Reflux in Children

Velázquez-Sarabia,

Sarabia-Alcocer,

López-Gutiérrez

et al. 2024

JHS

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“…As previously mentioned, the only indication for the surgical correction of VUR in the pediatric population in our service was recurrent febrile UTI. [ 4 , 8 ] All reviewed patients were diagnosed with reflux during adolescence and were allocated to follow-up only, without antibiotic prophylaxis, according to parental decisions or the choice of the primary physician. They returned to our attention because of recurrent febrile UTI.…”

Section: Methodsmentioning

confidence: 99%

“…The endoscopic correction technique was identical to that described for the pediatric population. [ 4 , 8 ] In patients with grade I–III VUR, we used the usual STING technique, introducing the needle submucosally under the ureteral orifice at the 6-o’clock position. In patients with grade IV VUR or in those with a wide ureteral orifice, the injection was performed inside the orifice as described previously.…”

Section: Methodsmentioning

confidence: 99%

“…During the last 4 years, we have adapted a lifting technique for the STING that allows for a more precise placement of the implant with an increased success rate. [ 8 ] Over the study period, we have used polytetrafluoroethylene (Teflon) as a tissue-augmenting substance, Dextranomer/Hyaluronic Acid Copolymer copolymer, and over the last 11 years, polyacrylate-polyalcohol copolymer, namely, Vantris.…”

Section: Methodsmentioning

confidence: 99%

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Our experience with management of congenital urological pathologies in adulthood: What pediatric urologists should know and adult urologists adopt in pediatric practice experience

Chertin,

Neeman,

Jaber

et al. 2023

Curr Urol

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Purpose To summarize our experience in the management of congenital anomalies in the kidney and urinary tract (CAKUT) in adults. Materials and methods We conducted a retrospective chart review of all adult patients who underwent primary surgical intervention for CAKUT between 1998 and 2021. Results The study included 102 patients with a median age of 25 (interquartile range, 23–36.5). Of these, 85 (83.3%) patients reported normal prenatal ultrasound, and the remaining 17 (16.7%) patients were diagnosed with antenatal hydronephrosis. These patients were followed up conservatively postnatally and were discharged from follow-up because of the absence of indications for surgical intervention or because they decided to leave medical care. All studied adult patients presented with the following pathologies: 67 ureteropelvic junction obstructions, 14 ectopic ureters, 9 ureteroceles, and 6 primary obstructive megaureters, and the remaining 6 patients were diagnosed with vesicoureteral reflux. Forty-three percent of the patients had poorly functioning moieties associated with ectopic ureters or ureteroceles. Notably, 67% of patients underwent pyeloplasty, 9% underwent endoscopic puncture of ureterocele, 3% underwent ureteral reimplantation, 6% underwent endoscopic correction of reflux, 7% underwent partial nephrectomy of non-functioning moiety, and the remaining 9% underwent robotic-assisted laparoscopic ureteroureterostomy. The median follow-up period after surgery was 33 months (interquartile range, 12–54). Post-operative complications occurred in 5 patients (Clavien-Dindo 1–2). Conclusions Patients with CAKUT present clinical symptoms later in life. Parents of patients diagnosed during fetal screening and treated conservatively should be aware of this possibility, and children should be appropriately counseled when they enter adolescence. Similar surgical skills and operative techniques used in the pediatric population may be applied to adults.

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Update and Summary of the European Association of Urology/European Society of Paediatric Urology Paediatric Guidelines on Vesicoureteral Reflux in Children

Gnech,

't Hoen,

Zachou

et al. 2024

European Urology

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Endoscopic Correction of Reflux Utilizing Polyacrylate Polyalcohol Bulking Copolymer (Vantris) as a Tissue Augmenting Substance: Lessons Learned Over the 10 Years of Experience

Cited by 5 publications

References 23 publications

Risk Factors Associated With Endoscopic Treatment of Vesicoureteral Reflux in Children

Risk Factors Associated With Endoscopic Treatment of Vesicoureteral Reflux in Children

Our experience with management of congenital urological pathologies in adulthood: What pediatric urologists should know and adult urologists adopt in pediatric practice experience

Update and Summary of the European Association of Urology/European Society of Paediatric Urology Paediatric Guidelines on Vesicoureteral Reflux in Children

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