Single institutional study on the effectiveness of cystoscopic injection of the tissue bulking agent-dextranomer hyaluronic acid copolymer (DxHA)‎ as a treatment of primary vesicoureteral reflux (VUR)‎ in children

Abstract EN

Objective: To evaluate the effectiveness of cystoscopic subureteric injection of Dextranomer/Hyaluronic Acid as are the liable and safe substitute to prophylactic antibiotic therapy and open surgical treatment in cases of primary vesicoureteral reflux (VUR) in children Materials and Methods: Retrospective study designed at Queen Rania Hospital for Children in Amman, Jordan between August 2015 and March 2018.

Sixty-three children were included in this study.

Twenty-seven are males and 36 are females.

Mean age of patients is seven years.

Eighty-nine refluxing ureters were injected.

Reflux grades in the 89 ureters were one in five children (5.6%), II in 16 children (17.9%), III in 29 children (32.5%), IV in 23 children (25.8%) and grade V in 16 children (17.9%).

The cystoscopic subureteric injection was performed using Dextranomer/Hyaluronic Acid as a tissue bulking agent.

Results: Vesicoureteral reflux was resolved after the first cystoscopic injection of Dextranomer/Hyaluronic Acid in 73 ureters (82%), downgraded in six ureters (6.7%) and never changed in10 (11.2%) ureters.

Those results were obtained via a follow-up Micturating Cystourethrogram (MCUG) done after three months of injection.

None of the patients in this study has experienced significant complications.

Conclusions: Cystoscopic suburetric injection of Dextranomer/Hyaluronic Acid is a safe and effective method of treatment in the management of vesicoureteral reflux (VUR) in children.

We recommend this minimally invasive, the short timed, ambulatory procedure as an excellent option for patients with primary vesicoureteral reflux giving a long term follow up to confirm the found results.