ESPU Congress 2018 - Abstract Book

49 11–14 APRIL, 2018, HELSINKI, FINLAND S4: VESICOURETERAL REFLUX 1 Moderators: Ram Subramaniam (UK), Kathy Herbst (USA) ESPU Meeting on Thursday 12, April 2018, 08:20–08:52 08:20–08:25 S4-1 (LO) ★ RANDOMIZED CLINICAL TRIAL BETWEEN POLYACRYLATE-POLYALCOHOL COPOLYMER (PPC) AND DEXTRANOMER-HYALURONIC ACID COPOLYMER (DX/HA) AS BULKING AGENTS FOR ENDOSCOPIC TREATMENT OF PRIMARY VESICOURETERAL REFLUX (VUR) GRADES III, IV AND V. Luis GARCIA-APARICIO  1 , Eva BLAZQUEZ-GOMEZ  2 , Sonia PÉREZ-BERTÓLEZ  1 , Jenny ARBOLEDA  1 , Oriol MARTIN  1 and Xavier TARRADO  3 1) Hospital Sant Joan de Déu. University of Barcelona, Pediatric Urology Division. Pediatric Surgery Department, Barcelona, SPAIN - 2) Hospital Sant Joan de Déu. University of Barcelona, Anaesthesiology Department, Barcelona, SPAIN - 3) Hospital Sant Joan de Déu. University of Barcelona, Pediatric Surgery Department, Barcelona, SPAIN PURPOSE The aim of our study is to compare the outcome of endoscopic treatment of VUR using PPC or Dx/HA. MATERIAL AND METHODS From October 2014 to April 2017 patients with VUR >= 3 that needed endoscopic treatment (ET) were eligible for this randomized clinical trial. Patients were randomized in two groups: PPC group and Dx/HA group. After endoscopic treatment a voiding cystourethrography (VCUG) was performed at 6 months; if VUR was still present a second and last ET was performed. Ureteral reimplantation was proposed if after two ET patient had a VUR>=3. Radiological success was considered if post- operative VUR grade was 0 and clinical success was considered if no more urinary tract infection (UTI) appeared. In bilateral cases, those ureters with VUR<3 were excluded. RESULTS Forty six patients were eligible but 2 did not accept the trial, then 44 patients with 63 refluxing ureters (RU)>=3 were included. PPC group: 21 patients (29 RU); and Dx/HA group: 23 patients (34 RU). Both groups were statistically homogeneous. Radiological success rate was 82.75 % of RU in PPC group and 79.4 % in Dx/HA group (p=0.496). Clinical success rate was 95.2 % of patients in PPC group and 91.3 % in Dx/HA group (p>0.05). There were no differences in the radiological success rate after one treatment. The volume of bulking agent used in those successfully treated is greater in Dx/HA group (p<0.05). After 2 endoscopic treatments, 3 patients with 5 RU in PPC group and 4 patients with 7 RU in Dx/HA group underwent ureteral reimplantation. On patient with 1 RU in Dx/HA were managed conservatively. Distal ureter in all cases of ureteral reimplantation post-PPC were excise, instead distal ureter was not excise in all ureters reimplanted post-Dx/HA injection. CONCLUSIONS PPC and Dx/HA has similar outcome, but we must warn that ureteral reimplantation after endo- scopic treatment with PPC is difficult because of the periureteral fibrosis.