Abstract
The current literature suggests that multiple variables affect vesicoureteric reflux (VUR) resolution rates following dextranomer/hyaluronic acid copolymer (Dx/HA) injection. This article reviews the evidence pertaining to the effect of injected Dx/HA volume on success rates following endoscopic correction. Lack of prospective studies which use injected volume as a continuous variable coupled with a nonstandardized injection technique and endpoint hinders the ability to reach a definite conclusion.
Highlights
The approval of dextranomer hyaluronic acid copolymer (Dx/HA) by the FDA in 2001, coupled with its safety and ease of injection, has led to a rapid increase in its use for treating vesicoureteral reflux (VUR) [1]. This has been accompanied by a reevaluation of the treatment philosophy for VUR, promulgated by both a change in physician preference and driven by parents who are opting for endoscopic correction over long-term follow up and antibiotic prophylaxis [2, 3]
Univariate and multivariate regression analysis were performed on the following variables: age at surgery, gender, laterality, time between presentation and surgery, preoperative VUR grade, surgeon experience, lower urinary tract symptoms (LUTS), and volume of Dx/HA injection
Dx/HA volume the first 98 ureters treated to 0.87 ± 0.29 mean Dx/HA volume (mL) in the last 98 (P = .002), a change that was associated with a simultaneous improvement in the success rate for grade III VUR from 50 to 68%
Summary
The current literature suggests that multiple variables affect vesicoureteric reflux (VUR) resolution rates following dextranomer/hyaluronic acid copolymer (Dx/HA) injection. This article reviews the evidence pertaining to the effect of injected Dx/HA volume on success rates following endoscopic correction. Lack of prospective studies which use injected volume as a continuous variable coupled with a nonstandardized injection technique and endpoint hinders the ability to reach a definite conclusion
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