Evaluation of the VANRIS Injection Success Rate in Vesicoureteral Reflux (VUR) Treatment in Children

Authors

1 Urology Resident, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran

2 Kidney Transplant Fellowship, Kidney Transplant Division, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran

3 Professor of Pediatric Nephrology, Nephrology and Kidney Transplant Research Center, Urmia University of Medical Sciences, Urmia, Iran

4 MSc Student Of Epidemiology, Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran

5 Pediatrics Specialist, Urmia University of Medical Sciences, Urmia, Iran

6 Professor of Kidney Transplant, Nephrology and Kidney Transplant Research Center, Urmia University of Medical Sciences, Urmia, Iran

7 Medicine Faculty and Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran.

Abstract

Background: Vesicoureteral reflux (VUR) is a common condition among children. Although, subureteral injection is a minimally invasive new method for VUR treatment, ideal bulking agent in endoscopic treatment still remains controversial. We aimed to evaluate VANTRIS subureteral injection efficacy in VUR treatment in pediatric patients.
Materials and Methods: All patients who referred to Imam Khomeini hospital in Urmia-Iran, Urology ward with VUR diagnosis that had indications for open surgery, enrolled study (during Mar 2013 to Mar 2015). Prior to intervention, VUR severity, urinary tract infection (UTI) and subsequent complications determined using urine analysis and imaging. Subsequently, single injection of the VANTRIS performed for all patients and patients underwent six-month follow up including several clinical and paraclinical evaluations.
Results: 31 patients with VUR diagnosis participated; of 31 patients, 18 (58.06%) children with primary UTI who had surgery indication enrolled study; of 18 patients, seven patients (38.88%) were boy and eleven patients (61.12%) were girl with mean age of 6.88 ± 2.61 years, and out of 29 refluxing rental units (RRU), 13 (44.8%) were right and 16 (55.2%) were left kidney. In current study, patients divided to two subgroups regarding their age older than five or younger than five years old and there was no significant difference between the resolution rates following VANTRIS injection in two groups (P>0.05). Eleven (38.88%) RRU detected in boy patients, nonetheless VUR resolved in all of them, postoperatively. On the other hand, of 18 RRU in female patients, complete VUR resolution observed in 16 kidneys (88.8 %), but only 2 (11.11%) kidneys had incomplete, but significant VUR resolution, where no significant difference observed. The prevalence of reflux in patients with UTI was 30% and in patients without UTI was 17%.
Conclusion: The current study indicated that in all age groups of patients, the subureteral injection of the VANTRIS was an accurate and effective treatment modality for VUR

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