ESPU Congress 2017 - Abstract book

CONGRESS OF THE ESPU

08:59–09:02

S5-2 (PP)

COMPARATIVE EVALUATION OF EFFICIENCY OF SINGLE

AND DOUBLE INJECTION TECHNIQUES FOR ENDOSCOPIC

TREATMENT OF VESICOURETERAL REFLUX IN CHILDREN

Svetlana BORISOVA, Sergei ZORKIN, Dmitry SHAKHNOVSKIY

and Eranui BARSEGYAN

Scientific Center of Children’s Health, Urology, Moscow, RUSSIAN FEDERATION

PURPOSE

Vesicoureteral reflux (VUR) endoscopic correction becomes a widespread first line procedure for

all grade reflux due to its undoubted advantages. To date two tissue-augmenting substances most

commonly employed: hyaluronic acid copolymer (Urodex) and polyacrylate/polyalcohol copolymer

(Vantris). The goal of this study was to evaluate the success rates of single and double injection

techniques for insufflation of these bulking agents.

MATERIAL AND METHODS

From 2012 to 2015, 540 children (227 boys and 313 girls) with a mean age of 2.8 years (range

4 months-12 years) were treated endoscopically with single (STING/HIT1) and double injection

(HIT2) techniques. Single injection we used in 386 patients (571 renal refluxing units (RRU)) and

double injection in 154 patients (236 RRU) with all grades of VUR. We employed both Urodex and

Vantris bulking agents. Positive outcome we considered to be a complete elimination of reflux after

a single injection. The effectiveness of injection was evaluated with voiding cystouretrography in

6 months.

RESULTS

For single injection VUR resolution rate was 73,9% and for double injection VUR resolution rate

was 86,4%. Double injection technique was more effective than single injection for both Urodex

(Pearson χ-squared 67,6, p=95%) and Vantris (Pearson χ-squared 10,17, p=95%). There was no

statistically significant difference in Urodex and Vantris effectiveness with double injection technique

(Pearson χ-squared 0,77, p=95%). Vesicoureteral junction obstruction, requiring ureteral reimplan-

tation, developed in 4 ureters, treated with Vantris (0,6%). Six patients (0,95%) developed febrile

urinary tract infection.

CONCLUSIONS

Our results confirm that double injection technique is more effective then single injection for endo-

scopic treatment of VUR. Urodex and Vantris injection effectiveness is the same in double injection

technique. There is a necessity for long-term follow-up of patients, treated with Vantris, due to

a possible late onset ureteral obstruction.