ENDOSCOPIC SUBURETERAL GLUTARALDEHYDE CROSS-LINKED COLLAGEN INJECTION FOR THE TREATMENT OF SECONDARY VESICOURETERAL REFLUX: COMPARISON WITH PRIMARY VESICOURETERAL REFLUX IN ADULTS
| Autor: | Tsuguru Usui, Akihiro Usui, Takahisa Nakamoto, Katsumi Inoue |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Urinary system Urology Glutaraldehyde-cross-linked collagen Injections Intralesional Vesicoureteral reflux Cerebral palsy Ureter Recurrence Absorbable Implants medicine Ureteroscopy Humans In patient Neural Tube Defects Child Aged Vesico-Ureteral Reflux medicine.diagnostic_test business.industry digestive oral and skin physiology Middle Aged medicine.disease digestive system diseases Surgery Endoscopy medicine.anatomical_structure Normal urination Glutaral Child Preschool Female Collagen business |
| Zdroj: | The Journal of Urology. :336-339 |
| ISSN: | 0022-5347 |
| Popis: | We assessed the effectiveness of endoscopic subureteral glutaraldehyde cross-linked collagen injection for treating vesicoureteral reflux in patients with vesicoureteral disorders.All 51 ureters studied had grade II or greater vesicoureteral reflux. We treated 18 patients (24 refluxing ureters) with secondary and 17 adults (27 refluxing ureters) with primary vesicoureteral reflux. The primary group served as controls to establish normal urination. A total of 14 patients with secondary vesicoureteral reflux had a low compliant autonomous bladder, including 11 with myelodysplasia and 3 after pelvic surgery and radiotherapy. One patient had an unstable bladder due to cerebral palsy and 3 had anatomical abnormalities of the urinary tract. We evaluated the estimated reflux-free rate in the secondary and adult primary vesicoureteral reflux groups.Repeat injection was required in 24 ureters because of recurrent reflux. Average injected volume in the secondary and primary groups was 2.72 and 2.88 ml. per refluxing unit, respectively. The estimated reflux-free rate after the initial injection decreased gradually to about 35% in each group, while 12 and 24 months after the last injection it remained constant at 70% in the secondary group but decreased from 84.7% to 62.1% in the primary group. The percent of late recurrence was higher in the primary group.Long-term efficacy of the endoscopic correction of vesicoureteral reflux in the secondary group was similar to that in the primary group. Thus, endoscopic subureteral glutaraldehyde cross-linked collagen injection is useful for treating complicated secondary vesicoureteral reflux as a minimally invasive procedure. It is considered optional treatment of primary vesicoureteral reflux to avoid long-term prophylactic treatment. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|