Endoscopic injection therapy for treatment of vesicoureteric reflux: A 20-year perspective

Leonard, Michael P.

doi:10.1093/pch/7.8.545

“…Use of injectable bulking agents for the treatment of UI and VUR is not new, as this dates back to many decades 15–21. These procedures involve injecting autologous fillers or synthetic biomaterials into the wall of the urethra or the distal ureter to make it fuller.…”

Section: Injectable Biomaterials As Bulking Agents For Treating Isd Omentioning

confidence: 99%

Injectable biomaterials for incontinence and vesico‐ureteral reflux: Current status and future promise

Tsai

¹

,

Lin

²

,

Tang

³

2005

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Many injectable biomaterials have been produced as bulking agents for compression of urethral sphincter or ureteral orifice for treating adult stress incontinence or vesico-ureteral reflux in pediatrics. The agents being developed include glutaraldehyde crosslinked collagen, dextranomer/hyaluronic acid copolymer, pyrolytic carbon-coated zirconium oxide beads, polydimethyl-siloxane microparticles, polytetrafluoroethylene paste, autologous fats, autologous chondrocytes, and others. Though less invasive nature of these agents has gained their popularity as a quick solution of the disease symptoms, most of such treatments fail to produce good long-term efficacy. The failure is likely caused by the rapid degradation of material implants and the lack of tissue regeneration/integration properties. We thus believe that a good injectable biomaterial for incontinence should possess the following two properties: (1) to resist degradation and to reside in the implantation sites for a long period of time or (2) to enhance tissue regeneration and to establish permanent periurethral or subureteric tissue. Here we report some recent results for supporting this hypothesis.

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“…Leonard 64 conclui que a terapia endoscópica pode ser oferecida como uma opção terapêutica para pacientes com indicação cirúrgica. O material ideal para injeção subureteral ainda deve ser desenvolvido, e neste sentido, parece ser promissor o campo de pesquisa na engenharia de tecidos autólogos.…”

Section: O Uso De Doses Baixas De Antimicrobianos a Longo Prazo é Efiunclassified

Infecção do trato urinário: em busca das evidências

Koch¹,

Zuccolotto²

2003

J. Pediatr. (Rio J.)

13

0

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ResumoObjetivo: no presente trabalho, visamos abordar o tema infecção do trato urinário à luz da evidência clínica atual.Fonte de dados: realizamos revisão bibliográfica no período de 1996 a 2002, utilizando os bancos de dados Medline e Cochrane, por meio das seguintes palavras-chave: infecção urinária, criança, adolescente, diagnóstico, tratamento e refluxo vesicoureteral. Foram selecionados estudos de coorte e de qualidade, consensos, metaanálises, ensaios randomizados controlados e auditorias.Síntese de dados: os artigos levantados foram selecionados com base em aspectos metodológicos, relevância e aplicabilidade clínica. Parte dos destaques dos artigos baseiam-se nos parâmetros propostos pela Academia Americana de Pediatria, em 1999, para o diagnós-tico e tratamento da infecção urinária febril da criança entre dois meses e dois anos de idade.Conclusão: grande parte das diretrizes para diagnóstico e tratamento da infecção urinária na infância ainda está baseada em opiniões consensuais e dogmáticas. Trabalhos multicêntricos, randomizados, controlados, duplo-cegos para intervenções são necessários para melhoria da qualidade do diagnóstico e da condução da infecção urinária na infância.J Pediatr (Rio J) 2003;79(Supl.1):S97-S106: infecção urinária, criança, adolescente, diagnóstico, tratamento, refluxo vesicoureteral. AbstractObjective: to review urinary tract infection in children taking into consideration evidence-based medicine.Sources of data: search of Medline and Cochrane databases, comprising the period between 1996 and 2002, with the following key words: urinary infection, vesicoureteral reflux, children, adolescents, diagnosis and treatment. Cohort studies, quality assurance studies, consensus, meta-analysis studies, randomized controlled trials and audits were selected.Summary of the findings: the studies were selected according to their methodology, relevance and clinical applicability. Some studies were selected based on the parameters proposed by the American Academy of Pediatrics in 1999 for the diagnosis and treatment of urinary tract infection in children between two months and two years of age.Conclusions: consensus statements on diagnosis and treatment of urinary infection in children and adolescents are still mostly opinion-based. Randomized multicentric controlled trials, with double-blind allocation are necessary to improve quality of diagnosis and management of pediatric urinary tract infection.J Pediatr (Rio J) 2003;79(Supl.1):S97-S106: urinary tract infection, child, adolescent, diagnosis, therapy, vesicoureteral reflux.

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Urinary tract infection: a search for evidence

Koch¹,

Zuccolotto²

2003

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ResumoObjetivo: no presente trabalho, visamos abordar o tema infecção do trato urinário à luz da evidência clínica atual.Fonte de dados: realizamos revisão bibliográfica no período de 1996 a 2002, utilizando os bancos de dados Medline e Cochrane, por meio das seguintes palavras-chave: infecção urinária, criança, adolescente, diagnóstico, tratamento e refluxo vesicoureteral. Foram selecionados estudos de coorte e de qualidade, consensos, metaanálises, ensaios randomizados controlados e auditorias.Síntese de dados: os artigos levantados foram selecionados com base em aspectos metodológicos, relevância e aplicabilidade clínica. Parte dos destaques dos artigos baseiam-se nos parâmetros propostos pela Academia Americana de Pediatria, em 1999, para o diagnós-tico e tratamento da infecção urinária febril da criança entre dois meses e dois anos de idade.Conclusão: grande parte das diretrizes para diagnóstico e tratamento da infecção urinária na infância ainda está baseada em opiniões consensuais e dogmáticas. Trabalhos multicêntricos, randomizados, controlados, duplo-cegos para intervenções são necessários para melhoria da qualidade do diagnóstico e da condução da infecção urinária na infância.J Pediatr (Rio J) 2003;79(Supl.1):S97-S106: infecção urinária, criança, adolescente, diagnóstico, tratamento, refluxo vesicoureteral. AbstractObjective: to review urinary tract infection in children taking into consideration evidence-based medicine.Sources of data: search of Medline and Cochrane databases, comprising the period between 1996 and 2002, with the following key words: urinary infection, vesicoureteral reflux, children, adolescents, diagnosis and treatment. Cohort studies, quality assurance studies, consensus, meta-analysis studies, randomized controlled trials and audits were selected.Summary of the findings: the studies were selected according to their methodology, relevance and clinical applicability. Some studies were selected based on the parameters proposed by the American Academy of Pediatrics in 1999 for the diagnosis and treatment of urinary tract infection in children between two months and two years of age.Conclusions: consensus statements on diagnosis and treatment of urinary infection in children and adolescents are still mostly opinion-based. Randomized multicentric controlled trials, with double-blind allocation are necessary to improve quality of diagnosis and management of pediatric urinary tract infection.J Pediatr (Rio J) 2003;79(Supl.1):S97-S106: urinary tract infection, child, adolescent, diagnosis, therapy, vesicoureteral reflux.

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Endoscopic injection therapy for treatment of vesicoureteric reflux: A 20-year perspective

Cited by 3 publications

References 38 publications

Injectable biomaterials for incontinence and vesico‐ureteral reflux: Current status and future promise

Injectable biomaterials for incontinence and vesico‐ureteral reflux: Current status and future promise

Infecção do trato urinário: em busca das evidências

Urinary tract infection: a search for evidence

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