Rao K Ln, Menon Prema, Samujh R, Mahajan J K, Bawa M, Malik M A, Mittal B R
Department of Pediatric Surgery, PGIMER, Chandigarh, India.
Department of Pediatric Surgery, PGIMER, Chandigarh, India. Correspondence to: Dr Prema Menon, Department of Pediatric Surgery, Advanced Pediatrics Centre, PGIMER, Chandigarh 160012, India,
Indian Pediatr. 2018 Dec 15;55(12):1046-1049.
To report our experience with endoscopic management of vesicoureteral reflux (VUR) by injection of a tissue bulking substance - Dextranomer/ hyaluronic acid co-polymer at vesicoureteric junction.
Retrospective analyses of case records.
Pediatric Surgery department in a tertiary care government Institute.
500 children (767 renal units) consecutively referred to the out-patient department with vesicoureteral reflux noted on micturating cysto-urethrogram (MCU) over a period of 13 years (2004-2016).
Preoperative VUR grading and renal scars on radionuclide scans were documented. Dextranomer hyaluronic acid copolymer was injected through a cystoscope at the vesicoureteral junction as a day care procedure under short anesthesia. Patients were followed (average duration 27.3 mo) with clinical assessment, periodic urine cultures and renal scans.
Cessation of VUR and symptomatic relief / clinical success postoperatively at 3 months.
Complete symptomatic relief was obtained in 482 (96.4%) patients. In 681 units where MCU was available, 614 (90%) units showed resolution of VUR.
Endoscopic injection of tissue bulking substances at vesicoureteric junction to stop VUR seems to be an effective intervention.
报告我们通过在膀胱输尿管交界处注射一种组织填充物质——葡聚糖/透明质酸共聚物来进行膀胱输尿管反流（VUR）内镜治疗的经验。
病例记录的回顾性分析。
一家三级护理政府机构的小儿外科。
在13年（2004 - 2016年）期间，500名儿童（767个肾单位）因排尿性膀胱尿道造影（MCU）显示膀胱输尿管反流而连续被转诊至门诊。
记录术前VUR分级及放射性核素扫描上的肾瘢痕情况。在短时间麻醉下，作为日间手术通过膀胱镜在膀胱输尿管交界处注射葡聚糖透明质酸共聚物。对患者进行随访（平均时长27.3个月），包括临床评估、定期尿培养及肾脏扫描。
术后3个月时VUR停止及症状缓解/临床成功。
482例（96.4%）患者获得完全症状缓解。在有MCU结果的681个肾单位中，614个（90%）肾单位显示VUR消失。
在内镜下于膀胱输尿管交界处注射组织填充物质以阻止VUR似乎是一种有效的干预措施。
