Tufan Tarcan1, Ilker Tinay, Yusuf Temiz, Ferruh Simşek. 1. Department of Urology, Marmara University School of Medicine, Marmara University Hospital, Tophanelioglu Caddesi 13-15, Altunizade, Istanbul, 34662, Turkey. tufan@marmara.edu.tr
Abstract
AIM: To review our long-term results of the sub-ureteric injection of calcium hydroxyapatite in the endoscopic management of vesicoureteral reflux (VUR) in children. MATERIALS AND METHODS: A sub-ureteric injection of calcium hydroxyapatite was given to 14 children (23 ureteral units) affected by VUR grades I-V. All children were followed-up with monthly urine cultures, and a renal ultrasound was done on the postoperative 4th week, while the first voiding cysto-urethrogram (VCUG) control was performed on postoperative week 12. The children were followed-up with yearly renal ultrasound and monthly urine cultures, thereafter. Data from the patients' charts were retrospectively analyzed regarding the outcome of the procedures. RESULTS: Mean follow-up time was 52 months (47-60 months). VUR was cured in 47.4% of cases after a single injection. After the second injection the global success rate was 52.1%. Ureteroneocystostomy was performed on seven refluxing ureters of five children unresponsive to sub-ureteric injection therapy. One patient underwent nephroureterectomy because of a non-functioning kidney secondary to ureteral obstruction due to migration of material at the 23rd month postoperatively. CONCLUSION: Although favorable short-term success rates have been reported with the sub-ureteric injection of calcium hydroxyapatite without any side effects, our long-term results showed a low success rate, with the only reported serious morbidity.
AIM: To review our long-term results of the sub-ureteric injection of calcium hydroxyapatite in the endoscopic management of vesicoureteral reflux (VUR) in children. MATERIALS AND METHODS: A sub-ureteric injection of calcium hydroxyapatite was given to 14 children (23 ureteral units) affected by VUR grades I-V. All children were followed-up with monthly urine cultures, and a renal ultrasound was done on the postoperative 4th week, while the first voiding cysto-urethrogram (VCUG) control was performed on postoperative week 12. The children were followed-up with yearly renal ultrasound and monthly urine cultures, thereafter. Data from the patients' charts were retrospectively analyzed regarding the outcome of the procedures. RESULTS: Mean follow-up time was 52 months (47-60 months). VUR was cured in 47.4% of cases after a single injection. After the second injection the global success rate was 52.1%. Ureteroneocystostomy was performed on seven refluxing ureters of five children unresponsive to sub-ureteric injection therapy. One patient underwent nephroureterectomy because of a non-functioning kidney secondary to ureteral obstruction due to migration of material at the 23rd month postoperatively. CONCLUSION: Although favorable short-term success rates have been reported with the sub-ureteric injection of calcium hydroxyapatite without any side effects, our long-term results showed a low success rate, with the only reported serious morbidity.
Authors: Robert A Mevorach; William C Hulbert; Ronald Rabinowitz; William A Kennedy; Barry A Kogan; John V Kryger; Anthony Caldamone; William R Clark; George W Kaplan; Charles T Durkee; Jack S Elder Journal: J Urol Date: 2006-01 Impact factor: 7.450
Authors: A A Malizia; H M Reiman; R P Myers; J R Sande; S S Barham; R C Benson; M K Dewanjee; W J Utz Journal: JAMA Date: 1984 Jun 22-29 Impact factor: 56.272