Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
J Urol. 2010 Feb;183(2):714-7. doi: 10.1016/j.juro.2009.10.047. Epub 2009 Dec 21.
We report the preliminary results of endoscopic treatment of vesicoureteral reflux in children using polyacrylate polyalcohol copolymer.
We performed a prospective multicenter review of pediatric patients treated with subureteral injection of a new nonabsorbable substance. Only patients with 1 year of followup were included.
A total of 83 patients underwent injection of polyacrylate polyalcohol copolymer at our institutions between 2005 and 2006. Among this group 18 males and 43 females with a median age of 58 months (range 9 months to 18 years) completed 1 year of followup. Reflux was bilateral in 27 patients (44.3%) and unilateral in 34 (55.7%). Number of injected ureters was 88. Reflux grade was V in 3 ureters (3.4%), IV in 12 (13.6%), III in 41 (46.6%) and II in 32 (36.4%). Mean +/- SD injected volume per unit was 0.76 +/- 0.43 ml. Median followup was 20 months (range 16 to 24). Complications after injection included dysuria in 6 patients (9.8%), fever in 3 (4.9%) and lumbar pain in 4 (6.6%). Reflux was eliminated in 78 renal units (88.6%), decreased to grade I in 6 (6.8%) and persisted in 4 (4.5%). Ureteral obstruction developed in 1 patient and was treated operatively. Overall success rate was 83.6%.
Polyacrylate polyalcohol copolymer can be used to treat vesicoureteral reflux with comparable efficacy to other substances currently used, with a low rate of complications.
我们报告使用聚丙烯酸聚醇共聚物治疗儿童膀胱输尿管反流的初步结果。
我们对使用新的不可吸收物质进行输尿管下注射治疗的儿科患者进行了前瞻性多中心回顾。仅包括有 1 年随访的患者。
2005 年至 2006 年期间，我们机构共对 83 例患者进行了聚丙烯酸聚醇共聚物注射。该组中 18 例男性和 43 例女性，中位年龄为 58 个月（范围 9 个月至 18 岁），完成了 1 年随访。反流双侧 27 例（44.3%），单侧 34 例（55.7%）。注射输尿管数为 88 个。反流等级为 3 个输尿管（3.4%）为 V 级，12 个（13.6%）为 IV 级，41 个（46.6%）为 III 级，32 个（36.4%）为 II 级。单位平均 +/- 标准差注射体积为 0.76 +/- 0.43 ml。中位随访时间为 20 个月（范围 16 至 24 个月）。注射后并发症包括 6 例（9.8%）排尿困难，3 例（4.9%）发热，4 例（6.6%）腰痛。78 个肾脏单位（88.6%）反流消除，6 个（6.8%）减少至 I 级，4 个（4.5%）持续存在。1 例发生输尿管梗阻，行手术治疗。总成功率为 83.6%。
聚丙烯酸聚醇共聚物可用于治疗膀胱输尿管反流，与目前使用的其他物质疗效相当，并发症发生率低。
