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Abstract
Vesicoureteral reflux (VUR) is a urinary tract anomaly that
affects approximately 1% of children and is a significant risk for the
development of long term renal damage.
VUR is commonly associated with urinary tract infections (UTIs),
and subsequent reflux of infected urine leading to pyelonephritis, renal
scarring, long term renal impairment and hypertension. Given the
potential for serious long term complications, early diagnosis and
treatment are of principal importance in children with this condition.
Treatment options for VUR include conservative medical
management or surgical management. The aim of treatment is to prevent
associated recurrent UTIs and subsequent renal damage and scarring.
Over the last 3 decades, endoscopic treatment of VUR has
secured a position in the treatment algorithm as an alternative to
conservative therapy and open surgery. It has gained popularity due to its
simplicity and convenience to patients.
It continues to evolve as new materials are being developed in an
attempt to find the ideal substance for this technique. Most recently a
Dextranomer/Hyaluronic acid (Dx/HA) copolymer was developed and
approved by the FDA in the USA for use in treatment of children with
VUR.
In this study, we investigate the efficacy, short term and
intermediate term results of the Dx/HA copolymer injection versus one
of the open surgical gold standard techniques, the extravesical
detrusorrhaphy, in the management of grades II-III of primary VUR in
children.