Summary
Since its introduction in 1984, endoscopic treatment of vesicoureteral reflux (VUR) has gained popularity and has proved successful in an increasing number of patients. Continuous improvements in injectable materials and increased experience with the technique have led to a broadening of the indications for endoscopic treatment.The authors report their experience with 1732 patients and 2455 refluxing ureters, treated over the past 20 years. From January 1986 to June 2005, 1732 patients underwent endoscopic treatment for grades II to V VUR. Polytetrafluoroethylene was injected as the bulking material in the first 14 cases; after 1989 bovine collagen was used in 442 cases, and starting in 1995 dextranomer/hyaluronic acid copolymer was used in 1276 cases.The followup protocol also changed over the years.The main changes consisted of time and number of micturition cystourethrograms (MCUG): in the first years MCUG was performed 3 and 12 months after endoscopic treatment; after 1999 a single MCUG was performed 3–6 months postoperatively. Minimum follow-up was 6 months.After one injection the overall success rate was 79% of ureters, and 91%, 78%, and 62% for grades II, III, and IV-V VUR, respectively. After the second injection, the overall success rate increased to 91%. Voiding dysfunction was identified as a possible limiting factor in the success of endoscopic treatment. Our results confirm that endoscopic treatment of VUR is a valid alternative to both long-term antibiotic prophylaxis and open surgery. The short hospital stay, the absence of significant postoperative complications, the safety of new injectable materials, and the increasingly high success rate suggest that endoscopic treatment should be offered as a first-line option to all children with VUR.
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© 2006 The Japanese Society of Endourology and ESWL
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Capozza, N., Zavaglia, D. (2006). Endoscopic Treatment of Vesicoureteral Reflux. In: Baba, S., Ono, Y. (eds) Interventional Management of Urological Diseases. Recent Advances in Endourology, vol 8. Springer, Tokyo. https://doi.org/10.1007/978-4-431-35642-4_6
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DOI: https://doi.org/10.1007/978-4-431-35642-4_6
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