Department of Pediatric Urology, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA.
Department of Pediatric Urology, Children's Healthcare of Atlanta and Emory University School of Medicine, Atlanta, GA.
Urology. 2014 Aug;84(2):462-8. doi: 10.1016/j.urology.2014.04.032. Epub 2014 Jun 26.
To determine the current preferred injection technique(s) for endoscopic management of pediatric vesicoureteral reflux (VUR). Since the approval of dextranomer hyaluronic acid copolymer (Dx/HA) in 2001, injection methods have evolved and now include the hydrodistention implantation technique (HIT) and double HIT as well as subureteral transurethral injection (STING) method.
In July 2012, 278 pediatric urologists in the United States were contacted to complete a 15-question survey regarding Dx/HA injection technique(s) currently used in their practice.
Fifty board-certified pediatric urologists completed the survey for a response rate of 18%. Most respondents (60%) were in a single-specialty group practice, and 12% were affiliated with an academic- or university-based practice. Respondents reported seeing a mean of 159 pediatric patients (range, 40-400 patients) with VUR annually, and 94% used Dx/HA ≥4 times in the past year. Forty-seven respondents (94%) reported using double HIT over the course of their career compared with 36 (72%) for STING and 30 (60%) for HIT (P <.05). Double HIT gained widespread acceptance between 2007 and 2008, paralleled by a decline in use of other injection techniques. A significantly higher percentage currently perform double HIT (92%) compared with either STING (24%) or HIT (34%; P <.001). Respondents reported the use of double HIT 15 times more often than STING technique and 5 times more often than HIT during the past 12 months (P <.001).
The double HIT method is currently the most commonly performed technique for endoscopic correction of VUR by pediatric urologists in the United States.
确定目前小儿膀胱输尿管反流（VUR）内镜治疗中首选的注射技术。自 2001 年批准使用葡聚糖透明质酸钠共聚物（Dx/HA）以来，注射方法已经发展，现在包括液压扩张植入技术（HIT）和双重 HIT 以及输尿管内注射技术（STING）。
2012 年 7 月，联系了美国 278 位小儿泌尿科医生，要求他们完成一份关于目前在实践中使用的 Dx/HA 注射技术的 15 个问题的调查。
50 名经过董事会认证的小儿泌尿科医生完成了调查，应答率为 18%。大多数应答者（60%）在单一专业团体执业，12%隶属于学术或大学基础实践。应答者报告称，每年平均诊治 159 例 VUR 小儿患者（范围为 40-400 例），94%的人在过去一年中至少使用 Dx/HA 4 次。47 名应答者（94%）报告在其职业生涯中使用双重 HIT，而 36 名（72%）用于 STING，30 名（60%）用于 HIT（P<.05）。双重 HIT 在 2007 年至 2008 年期间得到广泛认可，同时其他注射技术的使用减少。目前，进行双重 HIT 的比例明显高于 STING（24%）或 HIT（34%）（P<.001）。应答者报告在过去 12 个月中，双重 HIT 的使用频率比 STING 技术高 15 倍，比 HIT 高 5 倍（P<.001）。
双重 HIT 方法目前是美国小儿泌尿科医生治疗 VUR 的最常用内镜矫正技术。
