Chen Guangjie,Wang Xiaohao,Zhao Yijun,et al.A preliminary report of endoscopic injection of dextranomer/hyaluronic acid in children with primary vesicoureteral reflux[J].Journal of Clinical Pediatric Surgery,,18():820-824.[doi:10.3969/j.issn.1671-6353.2019.10.004]
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A preliminary report of endoscopic injection of dextranomer/hyaluronic acid in children with primary vesicoureteral reflux

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第18卷 Number: 2019 10 Page: 820-824 Column: 专题·原发性膀胱输尿管反流 Date of publication: 2019-10-28
Author(s):
Chen Guangjie1;  Wang Xiaohao1;  Zhao Yijun1;  Zhu Linfeng1;  Wei Jia1;  Gao Lei1;  Sun Long1;  Tao Chang1;  Xu Shan2;  Tang Daxing1
1. Department of Urology, Affiliated Children’s Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China;
2. Amcare Women & Children’s Hospital, Hangzhou 310012, China
Keywords:
Kidney/IN; Vesico-Ureteral Reflux; Injections; Hyaluronic Acid; Therapy
CLC:
R726.9;R692.2;R693
DOI:
10.3969/j.issn.1671-6353.2019.10.004
Abstract:
Objective To explore preliminarily the role of endoscopic injection of dextranomer/hyaluronic acid in children with primary vesicoureteral reflux.Methods From November 2017 to June 2019,a retrospective analysis was conducted for 15 children with primary vesicoureteral reflux receiving an endoscopic injection of dextranomer/hyaluronic acid.Experiment and control groups were randomly assigned.Experiment group(n=8) received an endoscopic injection of dextranomer/hyaluronic acid.Voiding cystourethrography was assessed at Week 12 post-operation.For ineffective cases,another injection was offered and re-examination performed at Week 52 post-operation.Reflux disappearing and degrading were judged successful and improving respectively.Control group(n=7) was treated with continuous antibiotic prophylaxis (CAP) of nitrofurantoin or sulfamethoxazole.Children with recurrent or uncontrolled urinary infection and renal function damage withdrew from clinical trial and received other treatments.Results Experiment group:8 children with 11 ureters.There were 3 boys and 5 girls with an age range of 12-186 months.The sideness was unilateral (n=5) and bilateral (n=3).And the involved side of ureter was left (n=7) and right (n=4); the grade of reflux was Ⅱ (n=2),Ⅲ (n=6) and Ⅳ (n=3).The injection dose was 0.2-2.0 ml.The injection mode was subureteral transurethral injection (n=9 in 6 children) and double hydrodistention implantation technique (n=2 in 2 children).Assessment at Week 12 post-operation revealed disappearing (n=2 grade Ⅲ),success rate 22.2%; degrading (n=3 grade Ⅲ; n=1 grade Ⅳ),improving rate 44.4%; unchanged (n=1 grade Ⅳ); upgrading (n=2 in 1 child,grade Ⅱ→Ⅲ).Two ureters were to be re-examined at Week 12 post-operation.Four ureters in 3 children received another injection.VCUG of 2 grade Ⅲ refluxing ureters at Week 52 post-operation revealed disappearing (n=1) and degrading (n=1 grade I).None of them showed any discomfort after injections.Control group:7 children with 8 ureters.There were 1 boy and 6 girls with an age range of 17-92 months.The sideness was unilateral (n=6) and bilateral (n=1).And the involved side of ureter was left (n=6) and right (n=2); the grade of reflux was Ⅱ (n=4),Ⅲ (n=3) and Ⅳ (n=1).CAP of nitrofurantoin or sulfamethoxazole was offered.For parental anxiety,two children with 2 grade Ⅲ ureters withdrew and switched to surgery.Re-examination at Week 52 indicated degrading (n=1 grade Ⅲ→Ⅰ).And the remainder were to be re-examined.Conclusion Endoscopic injection of dextranomer/hyaluronic acid is both safe and effective for children with primary vesicoureteral reflux.

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Memo

收稿日期:2019-09-04。
基金项目:国家重点研发计划（编号：2018YFC1002700）
通讯作者:唐达星,Emai:tangdx0206@zju.edu.cn

Last Update: 1900-01-01