Endoscopic correction of VUR using vantris as a new non-biodegradable tissue augmenting substance: three years of prospective follow-up.

OBJECTIVE: To evaluate the efficacy of Vantris in children with vesicoureteral reflux (VUR) after 3 years of prospective follow-up. MATERIAL AND METHODS: Over the last 3 years, 109 children (72 girls and 37 boys) with a mean age of 6.2 ± 3.4 years (mean ± SD) underwent endoscopic correction of reflux using Vantris. VUR was unilateral in 53 and bilateral in 56 patients comprising 165 renal refluxing units (RRUs). Of these, primary VUR was present in 139 RRUs (84.2%) and 26 (15.8%) were complex cases. Ultrasound scan was performed 1 month, 1 year, and 3 years after injection, and voiding cystourethrogram (VCUG) was performed 3 months, 1 year, and 3 years after endoscopic correction. RESULTS: The reflux was corrected in 153 RRUs (92.7%) after a single injection and in 7 RRUs (4.2%) after a second injection. In 5 RRUs (3.1%), VUR downgraded to grade I (3 RRUs) and grade II (2 RRUs) and they were taken off antibiotic prophylaxis. Two patients (1.8%) had afebrile urinary tract infections (UTIs) and 2 patients (1.8%) developed febrile UTI. VCUG was performed in 32 of 71 children (39.1%) who completed 1 year and in 6 of 15 (40%) who completed 3 years of follow-up. None showed VUR recurrence. Ultrasound scan demonstrated normal appearance of kidneys in all but 2 patients (1.8%). One patient required stent insertion because of deterioration of hydronephrosis that resulted in complete resolution of obstruction and another patient required ureteral reimplantation. CONCLUSION: Our data show that Vantris injection provides a high level of reflux resolution with good clinical outcome during prospective follow-up.

Preliminary data on endoscopic treatment of vesicoureteric reflux with polyacrylate polyalcohol copolymer (Vantris®): surgical outcome following single injection.

PURPOSE: The aim of this study was to evaluate the efficacy of single injection of a new non-biodegradable agent (Vantris(®)) Manufactured by Promedon, Cordoba, Argentina for treatment of vesicoureteric reflux (VUR). PATIENTS AND METHODS: 38 children (11 males and 27 females) with a mean age of 5.3 ± 3.8 years underwent endoscopic treatment of VUR using Vantris. VUR was unilateral in 17 and bilateral in 21 patients, comprising 59 renal refluxing units (RRU). The VUR was primary in 42 RRU and 17 comprised complex cases: 3 duplex systems, 1 with prune belly syndrome, and 13 after failed previous endoscopic correction with Deflux(®). VUR was Grade I in 5, II in 11, III in 23, IV in 15 and V in 5 RRU. RESULTS: All patients completed 3 months of follow up. The reflux was corrected in 56 (94.9%) of the 59 RRU (35/38 patients) after a single injection. Of the 38 patients, 21 completed 1 year of follow up, at which time ultrasound demonstrated no change compared with 1 month after injection. Eight of these 21 children underwent 1 year radionuclide cystography, and no reflux recurrence was shown. CONCLUSIONS: Our short-term data show that Vantris injection provides a high level of reflux resolution. Long-term follow up with this tissue-augmenting substance is required.