Randomized clinical trial between polyacrylate-polyalcohol copolymer (PPC) and dextranomer-hyaluronic acid copolymer (Dx/HA) as bulking agents for endoscopic treatment of primary vesicoureteral reflux (VUR)
| Autor: | L. García-Aparicio, J. Arboleda, Tarrado X, Sonia Pérez-Bertólez, E. Blázquez-Gómez, A. Soria, O. Martin |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Nephrology
Male medicine.medical_specialty Cystography Polymers Urology 030232 urology & nephrology Hydronephrosis Vesicoureteral reflux law.invention Injections Dextranomer/hyaluronic acid copolymer 03 medical and health sciences 0302 clinical medicine Cystourethrography Randomized controlled trial Lower urinary tract symptoms law Dextranomer-hyaluronic acid copolymer Internal medicine Medicine Humans Hyaluronic Acid Child Vesico-Ureteral Reflux business.industry Endoscopic treatment Dextrans Cystoscopy medicine.disease Polyacrylate-polyalcohol copolymer Treatment Outcome Homogeneous 030220 oncology & carcinogenesis Child Preschool Female business Tomography X-Ray Computed Follow-Up Studies |
| Zdroj: | WORLD J UROL r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu instname r-FSJD: Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu Fundació Sant Joan de Déu |
| ISSN: | 1433-8726 0724-4983 |
| Popis: | OBJECTIVE: To compare the radiological and clinical outcomes of endoscopic treatment of primary VUR using polyacrylate-polyalcohol copolymer (PPC-Vantris(®)) or dextranomer-hyaluronic acid copolymer (Dx/HA-Deflux(®)). MATERIALS AND METHODS: From October 2014 to April 2017, patients with primary VUR grade III to V that needed endoscopic treatment (ET) were eligible for this randomized clinical trial. We excluded toilet-trained patients with lower urinary tract symptoms. Patients were randomized and allocated into two groups: PPC group and Dx/HA group. After endoscopic treatment a voiding cystourethrography (VCUG) was performed at 6 months; if VUR was still present a second ET was performed. Radiological success was considered if postoperative VUR grade was 0 and clinical success rate was considered if no more fUTI appeared during follow-up. RESULTS: Forty-six patients were eligible but 2 did not accept the trial. Forty-four patients with 73 refluxing ureters were included. PPC: 34 refluxing ureters; and Dx/HA: 39 refluxing ureters. Both groups were statistically homogeneous and comparable. Mean follow-up was 27.6 months. Radiological success rate (82.2%) and clinical success rate (92.3%) were similar in both groups (p > 0.05). The volume of bulking agent used in those successfully treated was greater in Dx/HA group (p < 0.05). Distal ureter was excise in all cases of ureteral reimplantation after PPC treatment; however, distal ureter was preserved in all ureters reimplanted after Dx/HA injection. CONCLUSION: PPC and Dx/HA had similar outcomes, but we must warn that ureteral reimplantation after endoscopic treatment with PPC is difficult because of the periureteral fibrosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink