Boris Chertin1, Stanislav Kocherov. 1. Pediatric Urology Unit, Department of Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, P.O. Box 3235, Jerusalem 91031, Israel. boris.chertin@gmail.com
Abstract
OBJECTIVE: To review the current literature regarding the outcome of endoscopic treatment of vesicoureteric reflux (VUR) using different tissue-augmenting substances, with special emphasis on long-term efficacy. MATERIAL AND METHODS: The current literature, including our own experience, on long-term results after endoscopic treatment was reviewed by MEDLINE/PubMed search. RESULTS: The short-term results are similar in the majority of series to those of open surgery, but there is a high recurrence rate with use of dextranomer/hyaluronic acid (Deflux) as a tissue-augmenting material. CONCLUSIONS: There is a significant shortage of evidence-based literature on long-term follow-up after endoscopic correction of VUR utilizing dextranomer/hyaluronic acid. The high recurrence rate that has been reported after Deflux injection highlights a need for close observation beyond routine protocols and appropriate parental counseling upon endoscopic correction, and also the need to search further for alternative tissue-augmenting substances. The algorithm for treating VUR is yet to be finally determined. Copyright (c) 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
OBJECTIVE: To review the current literature regarding the outcome of endoscopic treatment of vesicoureteric reflux (VUR) using different tissue-augmenting substances, with special emphasis on long-term efficacy. MATERIAL AND METHODS: The current literature, including our own experience, on long-term results after endoscopic treatment was reviewed by MEDLINE/PubMed search. RESULTS: The short-term results are similar in the majority of series to those of open surgery, but there is a high recurrence rate with use of dextranomer/hyaluronic acid (Deflux) as a tissue-augmenting material. CONCLUSIONS: There is a significant shortage of evidence-based literature on long-term follow-up after endoscopic correction of VUR utilizing dextranomer/hyaluronic acid. The high recurrence rate that has been reported after Deflux injection highlights a need for close observation beyond routine protocols and appropriate parental counseling upon endoscopic correction, and also the need to search further for alternative tissue-augmenting substances. The algorithm for treating VUR is yet to be finally determined. Copyright (c) 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.