Turk Akif, Selimoglu Ahmet, Demir Kadir, Celik Osman, Saglam Erkin, Tarhan Fatih
Urology Clinic, Aksehir Public Hospital, Konya, Turkey.
Urology Clinic, Biga Public Hospital, Canakkale, Turkey.
Int Braz J Urol. 2014 May-Jun;40(3):379-83. doi: 10.1590/S1677-5538.IBJU.2014.03.12.
Aim of this study is to examine the effectiveness of dextranomer/hyaluronic acid copolymer and polyacrylate polyalcohol copolymer in endoscopic treatment of vesicoureteral reflux disease in adult patients with and without chronic renal failure.
Thirty two patients (12 female, 20 male) with a total of 50 renal units were treated for vesicoureteral reflux. There were 26 (81%) chronic renal failure patients. The success of treatment was evaluated by voiding cystouretrography at 3rd and 12th months after subureteric injection. The persistence of reflux was considered as failure. Patients were divided into two groups according to injected material. Age, sex, grade of reflux and treatment results were recorded and evaluated.
Reflux was scored as grade 1 in seven (14%), grade 2 in 16 (32%), grade 3 in 21 (42%) and grade 4 in six (12%) renal units. There was not patient with grade 5 reflux. Fourteen renal units (28%) were treated with dextranomer/hyaluronic acid copolymer (group 1) and 36 renal units (72%) were treated with polyacrylate polyalcohol copolymer (group 2). The overall treatment success was achieved at 40 renal units (80%). The treatment was successful at 11 renal units (79%) in group 1 and 29 renal units (81%) in group 2 (p = 0.71). There was not statistically significant difference between two groups with patients with chronic renal failure in terms of treatment success (p = 1.00).
The effectiveness of two bulking agents was similar in treatment of vesicoureteral reflux disease in adult patients and patients with chronic renal failure.
本研究旨在探讨葡聚糖/透明质酸共聚物和聚丙烯酸多元醇共聚物在内镜下治疗成年伴有或不伴有慢性肾衰竭的膀胱输尿管反流疾病中的有效性。
32例患者（12例女性，20例男性）共50个肾单位接受了膀胱输尿管反流治疗。其中26例（81%）为慢性肾衰竭患者。在输尿管下注射后第3个月和第12个月通过排尿性膀胱尿道造影评估治疗效果。反流持续存在被视为治疗失败。根据注射材料将患者分为两组。记录并评估患者的年龄、性别、反流程度及治疗结果。
7个（14%）肾单位反流评分为1级，16个（32%）为2级，21个（42%）为3级，6个（12%）为4级。无5级反流患者。14个肾单位（28%）接受了葡聚糖/透明质酸共聚物治疗（第1组），36个肾单位（72%）接受了聚丙烯酸多元醇共聚物治疗（第2组）。总体治疗成功率为40个肾单位（80%）。第1组11个肾单位（79%）治疗成功，第2组29个肾单位（81%）治疗成功（p = 0.71）。两组慢性肾衰竭患者在治疗成功率方面无统计学显著差异（p = 1.00）。
两种填充剂在治疗成年患者及慢性肾衰竭患者的膀胱输尿管反流疾病中有效性相似。
