Failure of subureteral bovine collagen injection for the endoscopic treatment of primary vesicoureteral reflux in long-term follow-up

Haferkamp, Axel; Contractor, H; Möhring, K.; Staehler, G.; Dörsam, J.

doi:10.1016/s0090-4295(00)00494-5

Cited by 73 publications

(39 citation statements)

References 18 publications

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“…PTFE paste injection resulted in particle migration to distant organs, such as the lungs and brain. [22][23][24][25] Although collagen is not likely to migrate, collagen did not conserve the initial volume 26,27 and sometimes caused allergic reactions or viral infections. 28 Silicone has been reported to have severe complications, such as chronic inflammation or migration.…”

Section: Introductionmentioning

confidence: 99%

The effect of microsphere degradation rate on the efficacy of polymeric microspheres as bulking agents: An 18‐month follow‐up study

et al. 2006

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The injection of bulking substances has been proposed as a new therapy to treat urinary incontinence and vesicoureteral reflux. Our previous study demonstrated that poly(lacticco-glycolic acid) (PLGA) microspheres have the potential to serve as a bulking agent for urological injection therapies. Hybrid tissues exhibiting a bulking effect were formed in vivo by PLGA microsphere injection, but long-term volume stability was not proven. In this study, we hypothesized that the biodegradation rate of the bulking substance (polymer microspheres) would affect the duration of volume conservation of the induced hybrid tissue. To test this hypothesis, rapidly degrading 75:25 PLGA microspheres and slowly degrading poly(L-lactic acid) (PLLA) microspheres were used as injectable bulking agents for the injection therapy. In vitro degradation tests showed that the mass losses of PLLA and PLGA were 16 and 96% of the initial masses, respectively, at 30 weeks. PLLA and PLGA microspheres were injected into the subcutaneous dorsum of mice. Both types of microspheres were easily injectable through 24-gauge needles. Histological examinations at various time points indicated that host cells from the surrounding tissues migrated to the spaces between both types of injected microspheres and formed new hybrid tissue structures. Lymphocyte migration was noted around the implanted PLGA and PLLA microspheres, but the inflammatory reaction diminished with time. Importantly, the volume of the PLLA hybrid tissues slowly decreased to 52% of the initial volume at 12 months and maintained that volume until 18 months, whereas the volume of the PLGA hybrid tissues rapidly decreased to 22% at 6 months, and the PLGA hybrid tissues disappeared at 11 months. These results show that the biodegradation rate of the bulking substance may be useful for controlling the duration of volume conservation of the induced hybrid tissue.

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Section: Introductionmentioning

confidence: 99%

The effect of microsphere degradation rate on the efficacy of polymeric microspheres as bulking agents: An 18‐month follow‐up study

et al. 2006

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“…Несмотря на перечисленные преимущества, при-менение коллагена и других фиксирующих веществ [1,3,[10][11][12] имеет достаточно высокий процент неудач. Эффективность метода оценивается разными авторами в пределах 67-80%.…”

Section: в помощь врачуunclassified

Comparative Evaluation of Surgical Correction Methods of Vesico-Ureteric Reflux in Children

Яцык¹,

Буркин²,

Шарков³

et al. 2014

Vopr. sovr. pediatr.

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“…Vezikoüreteral reflünün endoskopik tedavisi son dekatta popülarite kazanmıştır (1)(2)(3)(4). Hastaların subüreteral bölgesine endoskopik yolla hacim oluşturan ajan olarak ilk kez politetrafloraetilen (Teflon) enjekte eden Matouschek'ten (1) bu yana birçok ajan kullanılmıştır.…”

Section: ö öZ Ze Et Tunclassified

“…Ürolojide VUR'un tedavisinde hacimleştirici diğer bir ajan olan kollajenin kullanımı 1980'lerin sonunda yaygınlaşmıştır. Bu tarihten itibaren, literatürde VUR tedavisinde kollajenin etkinliği konusunda birçok karşıt yayın-lar mevcuttur (3,(5)(6)(7). Tedavi sonrası en büyük problem reflünün rekürrensine sebep olan implantın volüm kaybıdır (6-9).…”

Section: ö öZ Ze Et Tunclassified

Pri̇mer Vezi̇koüreteral Reflünün Tedavi̇si̇nde Endoskopi̇k Subüreteral Kollajen Enjeksi̇yonunun Uzun Dönem Etki̇nli̇ği̇

Nihat;KILIÇ¹

2004

Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Ö ÖZ ZE ET TPrimer vezikoüreteral reflünün (VUR) tedavisinde subüre-teral kollajen enjeksiyonunun uzun dönem etkinliğini retrospektif olarak değerlendirdik.Toplam 32 renal ünite subüreteral kollajen enjeksiyonu ile tedavi edildi. Grade 1, 4 ve 5 reflülü ve ciddi alt üriner sistem disfonksiyonlu hastalar çalışma dışı bırakıldı. Tek enjeksiyon sonrası 1. ayda halen reflüsü devam eden hastalar dışlandıktan sonra, 36 ay takibi tamamlayan 32 renal ünite çalışmaya dahil edilmiştir.6. ayda 32 renal üniteden 21'inde (%65.6) reflü yoktu. Tek enjeksiyon ve bir kez tekrarlanan enjeksiyon sonrası sırasıyla, 12 ay takipte 18 (%56.2) ve 22 (%68.7) renal ünitede halen reflü yoktu; 24 ay takipte 14 (%43.7) ve 17 (%53.1) renal ünitede reflü görülmedi. 36 aylık takiplerini tamamlayan reflülü 32 renal üniteli hastada tek enjeksiyon sonrası total kür oranı %31.2'dir (32 renal üniteden 10'u). Bir kez tekrarlanan enjeksiyon sonrası bu oran %40.6'dır (32 renal üniteden 13'ü). 36 aylık takip sonunda toplam 19 üretere reimplantasyon yapılmıştır.Kollajen enjeksiyonun uzun dönem takipte etkisiz olduğu-nu düşünmekteyiz. Bu yönteminin uzun dönem için etkinliğini belirlemede daha fazla sayıda çalışmaya ihtiyaç vardır. Ayrıca uzun dönem takipte, daha çok VCUG'lar ve eğer reflü tespit edilirse tekrarlayan enjeksiyonlar için daha fazla anestezi gerekecektir.A An na ah ht ta ar r K Ke el li im me el le er r: : Endoskopik Tedavi, Kollajen, Uzun Dönem Etkinlik, Vezikoüreteral Reflü.T Th he e L Lo on ng g T Te er rm m E Ef ff fe ec ct ti iv ve en ne es ss s O Of f E En nd do os sc co op pi ic c S Su ub bu ur re et te er ra al l C Co ol ll la ag ge en n I In nj je ec ct ti io on n I In n T Th he e T Tr re ea at tm me en nt t O Of f P Pr ri im ma ar ry y V Ve es si ic co ou ur re et te er ra al l R Re ef fl lu ux xWe retrospectively evaluated the long-term effectiveness of the subureteral collagen injection in the treatment of vesicoureteral reflux (VUR).A total of 32 renal units were treated with subureteric collagen injection. Patients with grade 1, 4 and 5 reflux and severe lower urinary tract dysfunctions, were excluded from the study. After excluding the patients who still had reflux at 1-month follow-up after single injection, 32 renal units with complete 36-month follow-up were included into the study.At 6 months there was no reflux in 21 of 32 (65.6%) renal units. At 12 months follow-up, there was still no reflux in 18 (56.2%) and 22 (68.7%) renal units; at 24 months follow-up, 14 (43.7%) and 17 (53.1%) renal units showed no reflux after single injection and one re-injection, respectively. In patients with 32 refluxing renal units, who completed their 36 months follow-up, overall cure rate of after single injection were 31.2% (10 out of 32 renal units). This rate was 40.6% (13 out of 32 renal units) after 1 repeat injection. A total of 19 ureter had been re-implanted at the end of 36 months follow-up.We think that, collagen injection is ineffective in the longterm follow-up. Further studies are needed to determine the effectiveness of this me...

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Failure of subureteral bovine collagen injection for the endoscopic treatment of primary vesicoureteral reflux in long-term follow-up

Cited by 73 publications

References 18 publications

The effect of microsphere degradation rate on the efficacy of polymeric microspheres as bulking agents: An 18‐month follow‐up study

The effect of microsphere degradation rate on the efficacy of polymeric microspheres as bulking agents: An 18‐month follow‐up study

Comparative Evaluation of Surgical Correction Methods of Vesico-Ureteric Reflux in Children

Pri̇mer Vezi̇koüreteral Reflünün Tedavi̇si̇nde Endoskopi̇k Subüreteral Kollajen Enjeksi̇yonunun Uzun Dönem Etki̇nli̇ği̇

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