Early Results of Endoscopic Treatment of Vesicoureteral Reflux with Polyacrylate Polyalcohol Copolymer

Abstract

Objective: To evaluate the early results of endoscopic treatment of vesicoureteral reflux (VUR) in children using polyacrylate polyalcohol copolymer (PPC). Patients and Methods: We retrospectively reviewed 45 patients treated with subureteric injection of PPC in our clinic. The results of voiding cystouretrography performed on the 3rd postoperative month and the results of 1-year follow-up were evaluated. Results: A total of 45 patients (57 ureters) underwent injection of PPC. The mean age of the patients was 6.5 years. There were 6 (10.5%) grade 1, 7 (12.2%) grade 2, 26 (45.6%) grade 3, 16 (28%) grade 4, and 2 (3.5%) grade 5 VUR. There were 11 overactive bladders, 2 duplex collecting systems, and 4 posterior urethral valves among the patients. Voiding cystouretrography postoperatively at the 3rd month showed that VUR had disappeared in 82.5% (47/57) of the ureters, downgraded to grade 2 and 3 in 7% (4/57), persisted in 5.2% (3/57) and upgraded in 5.2% (3/57). The success rate at the end of the first year was 98.1%. The procedure was free of complications such as fever, dysuria, lumbar pain or obstruction in all patients. No patient showed VUR recurrence at the end of the first year. Conclusions: The short-term results of our patients suggested that PPC can be safely and successfully used in the endoscopic treatment of VUR in children. However, further prospective, controlled trials showing the long-term results of the patients are needed.