Endourological application of polydimetilsiloxane in patients with symptomatic vesicoureteral reflux in the kidney graft

• Published in: Actas urológicas españolas (English ed.) 2019-06, Vol.43 (5), p.262-268
• Main Authors: Gutiérrez-Jiménez, A A, Jiménez-López, L A, Ricardez-Espinosa, A A, Santos-Uscanga, J P, Aguilar-Sandoval, E G, Vega-Tepos, I E, George-Micceli, E
• Format: Article
• Language: eng ; spa
• Subjects: Adolescent; Adult; Cross-Sectional Studies; Dimethylpolysiloxanes - therapeutic use; Female; Humans; Kidney; Kidney Transplantation; Male; Middle Aged; Odds Ratio; Pyelonephritis - epidemiology; Risk; Statistics, Nonparametric; Transplants; Treatment Outcome; Vesico-Ureteral Reflux - therapy; Young Adult
• ISSN: 2173-5786
• DOI: 10.1016/j.acuro.2019.01.004

To identify the results of polydimethylsiloxane application in the endourological management of symptomatic vesicoureteral reflux to the kidney graft and to determine the factors associated with persistent symptoms and with vesicoureteral reflux. We included 23 patients diagnosed with symptomatic VUR in kidney graft, evaluated from January 2010 to August 2018 in the High Specialty Medical Unit # 14 in Veracruz. These patients received endourological application of polydimethylsiloxane. The descriptive analysis was carried out, and, if possible, the relative risk measures for clinical failure (CF) were determined with odds ratio (OR). 18 (78.3%) patients presented clinical success (CS). There was a significant difference in the mean age (CS 30.61±9.7, CF 46.0±11.46; U Mann Whitney, P=.037), and in the number of episodes of AGPN prior to the application of PDMS (CS 2.27±1.27, CF 3.6±0.89, U Mann Whitney, P=.019). The most frequently identified pathogen was E. Coli, with 45.4%. VUR resolution was observed in 47.8% of the cases. There was a decreased degree of VUR in 73.9% of cases. A lower degree of VUR was determined as a protective factor for CF (OR: 0.031, 95% CI: 0.002-0.437, with P=.008). The endourological application of PDMS proved to be useful in the management of patients with symptomatic VUR in kidney graft, as it decreased the VUR degree and allowed CS in most cases.