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A Comparison of the Double Hydrodistention Implantation Technique (HIT) and the HIT with a Polyacrylate/polyalcohol Copolymer (PPC) for the Endoscopic Treatment of Primary Vesicoureteral Reflux

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Publisher Springer
Specialty Nephrology
Date 2014 Jun 27
PMID 24966099
Citations 2
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Abstract

Objectives: We aimed to compare the success rates of the double hydrodistention implantation technique (HIT) and the HIT with a polyacrylate/polyalcohol copolymer (PPC) for the treatment of primary vesicoureteral reflux (VUR) with a new nonbiodegradable tissue-augmenting substance (Vantris, Promedon, Cordoba, Argentina).

Methods: Between January 2011 and December 2012, fifty-two children who underwent subureteric injection for primary VUR are included. The children were randomly separated into two groups, the HIT and the double HIT groups, according to the type of injection. Success was defined as no reflux on a follow-up voiding cystourethrogram (VCUG) after 6 months. The patients were evaluated according to sex, age, grade of reflux, number of injections, and injected volume, and the radiological success rates were compared.

Results: Fifty-two patients underwent an endoscopic injection for primary grade III-V VUR. The HIT group consisted of 26 patients with 33 ureters, and the double HIT group consisted of 26 patients with 35 ureters. There were no significant differences in terms of the sex, ages, VUR grades, bilaterality between the two groups. The mean injected volumes were ml 1.12 (1.02-1.22) in the HIT group and 1.24 ml (95 % CI 1.10-1.38) in the double HIT group. The reflux was resolved in 21/33 (63.6 %) ureters in the HIT group and in 30/35 (85.7 %) ureters in the double HIT group, (p < 0.05). We had only one complication. This patient in the double HIT group, developed bilateral hydronephrosis and oliguric renal failure requiring open reimplantation at the sixth month.

Conclusion: We observed successful results double HIT method with PPC in Grade III-V reflux, but the long-term follow-up of patients is needed for hydronephrosis. As the double HIT treatment leads to a higher success rate, its use is preferable.

Citing Articles

Interventions for primary vesicoureteric reflux.

Williams G, Hodson E, Craig J Cochrane Database Syst Rev. 2019; 2:CD001532.

PMID: 30784039 PMC: 6380991. DOI: 10.1002/14651858.CD001532.pub5.


Endoscopic correction of vesicoureteral reflux in children using polyacrylate-polyalcohol copolymer (Vantris): 5-years of prospective follow-up.

Warchol S, Krzemien G, Szmigielska A, Bombinski P, Toth K, Dudek-Warchol T Cent European J Urol. 2017; 70(3):314-319.

PMID: 29104797 PMC: 5656363. DOI: 10.5173/ceju.2017.1226.

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