Evaluation of the intravesical ureters after failed endoscopic treatment of vesicoureteral reflux with dextranomer/hyaluronic acid in children via light and transmission electron microscopic analysis. A Matched Case-Control Study.

Evaluation of the intravesical ureters after failed endoscopic treatment of vesicoureteral reflux with dextranomer/hyaluronic acid in children via light and transmission electron microscopic analysis. A Matched Case-Control Study. Urol J. 2018 Aug 26;: Authors: Izol V, Kuyucu Y, Acikalin A, Deger M, Aridogan IA, Polat S, Satar N Abstract INTRODUCTION: The cytokine profile and the ultrastructural changes of refluxing ureterovesical junctions(UVJs) of children treated with failed dextranomer/hyaluronic-acid (Dx/HA) injections were investigated using immunohistochemical methods and transmission electron microscopy(TEM). PATIENTS AND METHODS: Eighteen children who underwent ureteroneocystostomy were included the study. The smooth muscle arrangement of the ureteral wall, transforming growth factor-?(TGF-?1),vascular-endothelial-growth factor(VEGF) and CD34 were evaluated immunohistochemically, and the results were compared with 10 age-matched autopsy specimens as controls. The ultrastructural evaluation and morphological description was made semi-quantitatively and compared with published data. RESULTS: Four of the patients(22%) were male, and 14(78%) were female. Erkek hastalar?n ortalama ya?? 8.5±4.9 y?l, k?zlar?nki ise 7.1±4.4 y?l idi (p=0.102).The mean age of the patients was 105.4±44.5(48-184) months. There was no correlation between the vesicoureteral reflux (VUR) grade and age (p= 0.85). The mean VEGF and CD34 scores were...
Source: Urology Journal - Category: Urology & Nephrology Authors: Tags: Urol J Source Type: research

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CONCLUSIONS: The Tc-99m DMSA scan remains the gold standard to detect renal parenchymal anomalies. A different length between the kidneys>1.11 SDS and dilated VUR are predictors of abnormal Tc-99m DMSA renal scan. PMID: 31726462 [PubMed - as supplied by publisher]
Source: Pediatric Research - Category: Pediatrics Authors: Tags: Pediatr Res Source Type: research
ConclusionsNew clinical aspect of diffuse alveolar hemorrhage is first reported to be associated with SAVI. Unsatisfactory therapeutic effects of tofacitinib are observed in this study and further evaluations are needed.
Source: Journal of Clinical Immunology - Category: Allergy & Immunology Source Type: research
Authors: Roy P, S R, MittalMittal R, Mehta S Abstract Vesicoureteral reflux (VUR) in children is often treated with antimicrobials for prolonged durations, which often leads to antimicrobial resistance. In this context, this review article discusses the use of endoscopic injection in VUR as a safe and efficacious option for these children. The literature pertaining to VUR- its clinical manifestation and management, antibiotic resistance- with special reference to management of VUR, and endoscopic dextranomer/hyaluronic acid gel injection for management of VUR was reviewed by identifying key words in a PubMed search...
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
AbstractPurpose of ReviewEndoscopic injection of bulking agents for the treatment of vesicoureteral reflux (VUR) has become a therapeutic alternative to antibiotic prophylaxis and ureteral reimplantation. Although considered as a safe and efficient procedure, several studies have reported cases of ureteral obstruction (UO) after endoscopic correction of VUR. This review article evaluates the present VUR literature to estimate the incidence of UO following endoscopic injection of different substances, while also discussing the impact of injection technique and implant volume.Recent FindingsTwenty-five publications were iden...
Source: Current Urology Reports - Category: Urology & Nephrology Source Type: research
ConclusionsA bilateral duplex collecting system with refluxing upper pole moiety ureter is a very rare entity. The diagnosis should be suspected when exploring any flank pain with recurrent urinary tract infections to avoid subsequent renal impairment. Furthermore, this case shows how some common symptoms may lead to finding an unexpected urinary tract abnormality.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
CONCLUSIONS: Compared with no treatment, the use of long-term, low-dose antibiotics may make little or no difference to the number of repeat symptomatic and febrile UTIs in children with VUR (low certainty evidence). Considerable variation in the study designs and subsequent findings prevented drawing firm conclusions on efficacy of antibiotic treatment.The added benefit of surgical or endoscopic correction of VUR over antibiotic treatment alone remains unclear since few studies comparing the same treatment and with relevant clinical outcomes were available for analysis. PMID: 30784039 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
AbstractObjectiveTo 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 methodsFrom 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...
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
Historically, patients with unilateral high-grade vesicoureteral reflux (VUR) and contralateral low-grade or resolved VUR have been treated with bilateral intravesical ureteral reimplantation, which requires postoperative admission. If the high-grade VUR side is treated alone, then the contralateral side is at risk of developing recurrent or worsening VUR. Bilateral subureteric injection of dextronomer/hyaluronic acid (DHA) is another option that can be performed as an outpatient therapy, but a single injection is less effective for high-grade VUR.
Source: Journal of Pediatric Urology - Category: Urology & Nephrology Authors: Source Type: research
Historically, patients with unilateral high-grade vesicoureteral reflux (VUR) and contralateral low-grade or resolved VUR have historically been treated with bilateral intravesical ureteral reimplantation, which requires postoperative admission. If the high-grade VUR side is treated alone, then the contralateral side is at risk of developing recurrent or worsening VUR. Bilateral subureteric of dextronomer/hyaluronic acid (DHA) is another option that can be performed as an outpatient, but a single injection is less effective for high-grade VUR.
Source: Journal of Pediatric Urology - Category: Urology & Nephrology Authors: Source Type: research
ConclusionThe use of resorbable dextranomer/hyaluronic acid material was related to recurrence in the endoscopic treatment of VUR. The high-grade reflux and treatment at an early age, as well as the presence of urinary dysfunction, are also factors associated with recurrence.ResumenIntroducciónLos resultados del tratamiento endoscópico del reflujo vesicoureteral (RVU) a corto plazo son excelentes. No obstante, con el paso de los años se ha identificado un número de pacientes en quienes el RVU que fue resuelto mediante esta técnica vuelve a aparecer. El objetivo de este trabajo es analizar...
Source: Actas Urologicas Espanolas - Category: Urology & Nephrology Source Type: research
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