Efficacy and Safety of Polyacrylate Polyalcohol Co-polymer (Vantris) Injection Material in the Endoscopic Treatment of VUR in Children: 3 Years of Prospective Follow Up | ||
Iraqi Postgraduate Medical Journal | ||
Article 10, Volume 20, Issue 1, January 2021, Pages 58-66 PDF (243.99 K) | ||
Document Type: Research Paper | ||
DOI: 10.52573/ipmj.2021.167827 | ||
Authors | ||
Muthanna Habeeb Abid1; Abdullah Amir Kadhum2 | ||
1College of Medicine, University of Kufa, Al-Najaf Al-Ashraf, Iraq | ||
2Department of urology, Al- Sadr Medical City, Al-Najaf Al-ashraf, Iraq | ||
Abstract | ||
BACKGROUND: To evaluate the safety, efficacy and durability of Vantris injection over a period of 3 years. PATIENTS AND METHOD: From 2015 to 2018 we followed 40 patients {male 14, female 26} with a mean age of 4.2±3.4 years (mean ± SD) underwent endoscopic Vantris injection therapy for treatment of primary vesicoureteral prospectively by voiding cystourethrogram at 3months, 1 year and 3 years. Those 40 patients comprising 70 refluxing renal unit (RRU), were unilateral in 10 patients and bilateral in 30 patients. Those were grade II in 10 RRU, grade III in 35 RRU and grade IV in 25 RRU. The volume of injected Vantris material was 0.8ml (range 0.4-1.2 ml) per refluxing unit. The patients were followed. Ultrasound was used at 1 week, 1 month and yearly for 3 years. RESULTS: All patients completed 3 years follow up by voiding cystourethrogram. At 3months VCUG 1 was done and shows: 10/10 RRU of grade II, 32/35 RRU of grade III and 23/25 RRU of grade IV show complete resolution of reflux, Success rate is 92.85%. At 1year VCUG 2 was done and shows: 10/10 RRU of grade II, 32/32 of grade III and 21/23 of grade IV show complete resolution of reflux, Success rate is 96.92%. At 3years VCUG 3 was done and shows: 10/10 RRU of grade II, 32/32 of grade III and 21/21 of grade IV show complete resolution of reflux, Success rate is 100%. The overall success rate is 63/70 (90%). CONCLUSION: Endoscopic injection of Vantris material for treatment of vesicoureteral reflux in children is very effective, safe and durable, and can be considered as first line treatment of grade Ⅱ-Ⅳ vesicoureteral reflux. | ||
Keywords | ||
Vantris; Injection therapy; VUR | ||
References | ||
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1. Lebowitz RL, Olbing H, Parkkulainen KV, et al. International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children. Pediatr Radiol 1985;15:105–9.
2. Greenfield SP, Ng M, Wan J. Experience with vesicoureteral reflux in children: clinical charac-teristics. J Urol 1997;158:574–7. 3. Jakobsson B, Soderlundh S, Berg U. Diagnostic significance of 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy in urinary tract infection. Arch Dis Child 1992;67:1338–42. 4. Wennerstrom M, Hansson S, Jodal U, et al. Disappearance of vesicoureteral reflux in children. Arch Pediatr Adolesc Med 1998;152:879–83. 5. Jacobson SH, Hansson S, Jakobsson B. Vesico-ureteric reflux: occurrence and long-term risks. Acta Paediatr Suppl 1999;88:22–30. 6. Hansson S, Martinell J, Stokland E, et al. The natural history of bacteriuria in childhood. Infect Dis Clin North Am 1997;11:499–512. 7. Devriendt K, Groenen P, Van Esch H, et al. Vesico-ureteral reflux: a genetic condition? Eur J Pediatr 1998;157:265–71. 8. Jerkins GR, Noe HN. Familial vesicoureteral reflux: a prospective study. J Urol 1982;128:774–8. 9. Noe HN, Wyatt RJ, Peeden Jr JN, et al. The transmission of vesicoureteral reflux from parent to child. J Urol 1992;148:1869–71. 10.Scott JE, Swallow V, Coulthard MG, et al. Screening of newborn babies for familial ureteric reflux. Lancet 1997;350:396–400. 11.Kaefer M, Curran M, Treves ST, et al. Sibling vesicoureteral reflux in multiple gestation births. Pediatrics 2000;105:800–4. 12.Rothwell DL, Constable AR, Albrecht M. Radionuclide cystography in the investigation of vesicoureteric reflux in children. Lanc1997;1:1072–5. 13.Edwards D, Normand IC, Prescod N, et al. Disappearance of vesicoureteric reflux during long- term prophylaxis of urinary tract infection in children. BMJ 1997;2:285–8. 14.Walker RD. Vesicoureteral reflux update: effect of prospective studies on current management. Urology 1994;43:279 –83. 15.Matouschek E: Treatment of vesicorenal reflux by transurethral teflon-injection (author’s transl). 1981 Urologe A. 20:263-264. 16.O’Donnell B, Puri P: Endoscopic correction of primary vesicoureteric reflux. Br J Urol. 58:601-604 1986. 29. | ||
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