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)

Objective To compare the radiological and clinical outcomes of endoscopic treatment of primary VUR using polyacrylate-polyalcohol copolymer (PPC-Vantris ® ) or dextranomer-hyaluronic acid copolymer (Dx/HA-Deflux ® ). Materials and methods From October 2014 to April 2017, patients with primary VUR gr...

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Bibliographic Details
Published in:World journal of urology 2018-10, Vol.36 (10), p.1651-1656
Main Authors: García-Aparicio, L., Blázquez-Gómez, E., Martin, O., Pérez-Bertólez, S., Arboleda, J., Soria, A., Tarrado, X.
Format: Article
Language:English
Subjects:
Child
Child, Preschool
Clinical trials
Cystography
Cystoscopy
Dextrans - administration & dosage
Endoscopy
Female
Fibrosis
Follow-Up Studies
Humans
Hyaluronic acid
Hyaluronic Acid - administration & dosage
Hydronephrosis - diagnostic imaging
Injections
Male
Medicine
Medicine & Public Health
Nephrology
Oncology
Original Article
Patients
Polyacrylate
Polymers - administration & dosage
Success
Tomography, X-Ray Computed
Treatment Outcome
Ureter
Urinary tract
Urology
Vesico-Ureteral Reflux - diagnostic imaging
Vesico-Ureteral Reflux - therapy
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Summary:Objective To compare the radiological and clinical outcomes of endoscopic treatment of primary VUR using polyacrylate-polyalcohol copolymer (PPC-Vantris ® ) or dextranomer-hyaluronic acid copolymer (Dx/HA-Deflux ® ). Materials and methods From October 2014 to April 2017, patients with primary VUR grade III to V that needed endoscopic treatment (ET) were eligible for this randomized clinical trial. We excluded toilet-trained patients with lower urinary tract symptoms. Patients were randomized and allocated into 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 ET was performed. Radiological success was considered if postoperative VUR grade was 0 and clinical success rate was considered if no more fUTI appeared during follow-up. Results Forty-six patients were eligible but 2 did not accept the trial. Forty-four patients with 73 refluxing ureters were included. PPC: 34 refluxing ureters; and Dx/HA: 39 refluxing ureters. Both groups were statistically homogeneous and comparable. Mean follow-up was 27.6 months. Radiological success rate (82.2%) and clinical success rate (92.3%) were similar in both groups ( p  > 0.05). The volume of bulking agent used in those successfully treated was greater in Dx/HA group ( p  
ISSN:0724-4983
1433-8726
DOI:10.1007/s00345-018-2314-7