Journal List > Korean J Urol > v.48(1) > 1004982

Sung, Park, and Park: Experience of Subureteral Polydimethylsiloxane Injection Treatment in Children with Vesicoureteral Reflux

Abstract

Purpose

Our data was retrospectively reviewed to assess the efficacy, safety and costs of endoscopic subureteral polydimethylsiloxane (PDS, Macroplastique®) injection treatment for children with vesicoureteral reflux (VUR).

Materials and Methods

Between December 1997 and May 2006, a total of 24 (29 renal units) VUR patients, whose parents showed reluctance toward open surgery, underwent subureteral PDS injection treatment. All of the patients were postoperatively assessed by voiding cystourethrography (VCUG) and ultrasound to evaluate any complications and reflux. The medical costs of the injection treatment were compared with those of open surgery for VUR over the same period.

Results

The mean follow-up was 15 months (range 2-72). Of the 29 renal units treated, 24 (82.8%) were cured. Hydronephrosis, which postoperatively developed in three renal units, was spontaneously improved or resolved after minimal endourological procedures. Temporary gross hematuria and voiding difficulty occurred in one patient each, but were also improved. The total medical costs of the injection treatment were cheaper than those of open surgery (p<0.05).

Conclusions

An endoscopic subureteral PDS injection is an effective and safe procedure; in addition, compared to open surgery, is an economic treatment for children with VUR.

Figures and Tables

Fig. 1
Outcomes of subureteral PDS injection treatment for VUR. *: one of the bilateral refluxing ureters in a bilateral duplicated system improved from GIII to GI, but the patient was lost to follow-up, : two patients with persistent VUR GIII, with newly developed contralateral GII VUR, were finally lost to follow-up, : one patient persisted after a 2nd injection, and was cured after open surgery. PDS: polydimethylsiloxane, VUR: vesicoureteral reflux.
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Table 1
The medical costs needed for unilateral VUR treatment according to the surgical techniques (1,000 won)
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PDS: polydimethylsiloxane, VUR: vesicoureteral reflux, *: comparison of the medical costs of the injection treatment with those of open surgery in a day surgery setting, : comparison of the medical costs of the injection treatment with those of open surgery in an admission surgery setting

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