Endoscopic Subureteral Injection for the Treatment of Vesicoureteral Reflux in Children: Polydimethylsiloxane (Macroplastique?) versus Dextranomer/Hyaluronic Acid Copolymer (Deflux?)
배영대, 오미미, 문두건, 박민구,
소속 상세정보
배영대 ( Bae Young-Dae )
고려대학교 의과대학 비뇨기과학교실
오미미 ( Oh Mi-Mi )
고려대학교 의과대학 비뇨기과학교실
문두건 ( Moon Du-Geon )
고려대학교 의과대학 비뇨기과학교실
박민구 ( Park Min-Gu )
고려대학교 의과대학 비뇨기과학교실
KMID : 0358320100510020128
Abstract
Purpose: The aim of this study was to compare cure rates and complications of polydimethylsiloxane (Macroplastique?) and dextranomer/hyaluronic acid copolymer (Deflux?) in the treatment of vesicoureteral reflux (VUR)
Materials and Methods : From April 2001 to March 2008, 29 boys and 42 girls (total of 115 ureters) with a mean age of 6 years who had undergone endoscopic subureteral transurethral injection for VUR were enrolled. A single subureteral injection of Macroplastique was performed in 31 ureters in 23 children (group I; grade II: 4; grade III: 12; grade IV: 9; grade V: 6), and a single subureteral injection of Deflux was performed in 84 ureters in 48 children (group II; grade II: 24; grade III: 14; grade IV: 25; grade V: 21). Renal ultrasound was done 1 day after injection, and voiding cystourethrography (VCUG) was done at 3 months. Successful reflux correction was defined as absent or grade I reflux on follow-up VCUG.
Results: No significant difference in success rates was observed between group I and group II [80.6% (25/31) vs. 78.6% (66/84), respectively, p＞0.05]. The following postoperative complications developed: ureteral obstruction in 2 ureters of group I and 3 ureters of group II, asymptomatic urinary tract infection in 3 patients of group I and 2 patients of group II, and bladder calcification by erosion or mucosal necrosis in 2 patients of group I.
Conclusions: Despite differences in material properties, both Macroplastique and Deflux were safe for the treatment of children with VUR. Because of the risk of bladder mucosal necrosis and substantial decreases in volume after implantation, long-term follow-up is required.
키워드
Vesicoureteral reflux;Deflux
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