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• W2113752024 abstract "No AccessJournal of UrologyVesicoureteral Reflux1 Oct 2008Intra-Orifice Versus Hydrodistention Implantation Technique in Dextranomer/Hyaluronic Acid Injection for Vesicoureteral Reflux Amit Gupta and Warren Snodgrass Amit GuptaAmit Gupta More articles by this author and Warren SnodgrassWarren Snodgrass More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2008.04.073AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Original implantation procedures used dextranomer/hyaluronic acid to create a volcano-like mound at the orifice. Subsequently the hydrodistention implantation technique was described to coapt the intramural ureteral wall with less emphasis on achieving a mound at the orifice and it was reported to be associated with improved outcomes. We compared the results of intra-orifice injection to establish a mound vs the hydrodistention implantation technique. Materials and Methods: Univariate and multivariate logistic regression analysis was used to compare results in 96 ureters undergoing intra-orifice injection vs 52 undergoing the hydrodistention implantation technique. We evaluated patient gender and age, reflux grade, injection technique, injected volume and the number of injection sites. Results: Successful reflux resolution was achieved in 124 ureters (84%) with a single implantation, including 83 (86.5%) with intra-orifice injection and 41 (79%) with HIT (p = 0.23). Mean injected volume was significantly increased for the hydrodistention implantation technique vs intra-orifice injection (0.68 vs 0.51 cc, p = 0.002). Univariate analysis showed that female gender, older age, reflux grade and number of injection sites were associated with success. On multivariate analysis only reflux grade remained significant. Conclusions: Despite using an increased volume of dextranomer/hyaluronic acid to coapt the intramural ureter and orifice, the hydrodistention implantation technique did not improve results over those of intra-orifice injection with a lesser implant volume. References 1 : A new bioimplant for the endoscopic treatment of vesicoureteral reflux: experimental and short-term clinical results. J Urol1995; 154: 800. Link, Google Scholar 2 : Minimally invasive treatment of vesicoureteral reflux with endoscopic injection of dextranomer/hyaluronic acid copolymer: the Children's Hospitals of Atlanta experience. J Urol2003; 170: 211. Link, Google Scholar 3 : The modified sting procedure to correct vesicoureteral reflux: improved results with submucosal implantation within the intramural ureter. J Urol2004; 171: 2413. Link, Google Scholar 4 : Long-term followup of children treated with dextranomer/hyaluronic acid copolymer for vesicoureteral reflux. J Urol2001; 166: 1887. Link, Google Scholar 5 : Multivariate analysis of factors predicting success with dextranomer/hyaluronic acid injection for vesicoureteral reflux. J Urol2007; 177: 1505. Link, Google Scholar 6 : Duplex kidneys: a correlation of renal dysplasia with position of the ureteral orifice. J Urol1975; 114: 274. Link, Google Scholar 7 : Subureteral injection of Deflux for correction of reflux: analysis of factors predicting success. Urology2005; 65: 564. Google Scholar 8 : A review of failures of endoscopic treatment of vesicoureteral reflux with dextranomer microspheres. J Urol2007; 177: 710. Link, Google Scholar 9 : Multivariate comparison of the efficacy of intraureteral versus subtrigonal techniques of dextranomer/hyaluronic acid injection. J Urol2007; 178: 1702. Link, Google Scholar Pediatric Urology Section, University of Texas Southwestern Medical Center and Children's Medical Center, Dallas, Texas© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byPuri P, Kutasy B, Colhoun E and Hunziker M (2012) Single Center Experience with Endoscopic Subureteral Dextranomer/Hyaluronic Acid Injection as First Line Treatment in 1,551 Children with Intermediate and High Grade Vesicoureteral RefluxJournal of Urology, VOL. 188, NO. 4S, (1485-1489), Online publication date: 1-Oct-2012. Volume 180Issue 4SOctober 2008Page: 1589-1593 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordsurinary bladderureterdextranomer/hyaluronic acid copolymervesico-ureteral refluxMetricsAuthor Information Amit Gupta More articles by this author Warren Snodgrass More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2113752024 title "Intra-Orifice Versus Hydrodistention Implantation Technique in Dextranomer/Hyaluronic Acid Injection for Vesicoureteral Reflux" @default.
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