Document Detail


Postoperative ureteral obstruction after endoscopic treatment of vesicoureteral reflux with polyacrylate polyalcohol copolymer (Vantris®).
MedLine Citation:
PMID:  23219423     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate the incidence and presentations of ureteral obstruction following periureteral injection of polyacrylate polyalcohol copolymer (PPC) for the treatment of vesicoureteral reflux (VUR).
MATERIALS AND METHODS: From Jan 2010 to Dec 2012, 88 patients (28 male, 60 female) with 128 renal refluxing units (RRU), 131 ureters and a mean age of 6.7 ± 5.9 years (range: 4 months to 32 years) underwent endoscopic correction of their VUR, using PPC. Exclusion criteria were dysmorphic appearing distal ureter, extravesical position of the ureteral orifice, persistent urethral obstruction (e.g. after previous valve ablation) and severe bladder trabeculation, making ureteral orifice unidentifiable. Patients were followed up by ultrasound one month after the injection and then every three months. Cystography was performed 3 months post-operation. Mean follow-up time was 13.1 ± 6.8 months (range: 3-27 months).
RESULTS: Two patterns of obstruction were observed: early, during the first 3-4 days post-operation, in four patients (4 ureters; 3%) which was associated with transient hydroureteronephrosis (HUN) in 2 patients (2 ureters; 1.5%); and late-onset obstruction in 3 patients (4 ureters; 3%) which appeared 3 months to 1 year after surgery. It manifested itself by urinary tract infection and uremia in one patient with bilateral obstruction but was asymptomatic in the other two. Early obstruction was managed expectantly and resolved in 3-12 months; however, late-onset obstruction needed catheter placement or open ureteroneocystostomy.
CONCLUSIONS: Patients who undergo endoscopic treatment for their VUR using PPC need long-term follow up until the safety of this substance is confirmed.
Authors:
Farshid Alizadeh; Hamid Mazdak; Mohammad H Khorrami; Pooyan Khalighinejad; Pourya Shoureshi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-12-06
Journal Detail:
Title:  Journal of pediatric urology     Volume:  9     ISSN:  1873-4898     ISO Abbreviation:  J Pediatr Urol     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-06-26     Completed Date:  2014-02-11     Revised Date:  2014-05-26    
Medline Journal Info:
Nlm Unique ID:  101233150     Medline TA:  J Pediatr Urol     Country:  England    
Other Details:
Languages:  eng     Pagination:  488-92     Citation Subset:  IM    
Copyright Information:
Copyright © 2012. Published by Elsevier Ltd.
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MeSH Terms
Descriptor/Qualifier:
Acrylic Resins / therapeutic use*
Adolescent
Adult
Biocompatible Materials / therapeutic use
Child
Child, Preschool
Endoscopy / adverse effects*
Female
Follow-Up Studies
Humans
Hydronephrosis / epidemiology,  surgery,  therapy
Incidence
Male
Postoperative Complications / epidemiology*,  surgery,  therapy
Ureteral Obstruction / epidemiology*,  surgery,  therapy
Vesico-Ureteral Reflux / epidemiology,  surgery*
Young Adult
Chemical
Reg. No./Substance:
0/Acrylic Resins; 0/Biocompatible Materials; 0/Vantris
Comments/Corrections
Comment In:
J Urol. 2014 May;191(5):1408-9   [PMID:  24745537 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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