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Long-term results of endoscopic treatment of vesicoureteral reflux with the sub-ureteric injection of calcium hydroxyapatite

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Abstract

Aim

To review our long-term results of the sub-ureteric injection of calcium hydroxyapatite in the endoscopic management of vesicoureteral reflux (VUR) in children.

Materials and methods

A sub-ureteric injection of calcium hydroxyapatite was given to 14 children (23 ureteral units) affected by VUR grades I–V. All children were followed-up with monthly urine cultures, and a renal ultrasound was done on the postoperative 4th week, while the first voiding cysto-urethrogram (VCUG) control was performed on postoperative week 12. The children were followed-up with yearly renal ultrasound and monthly urine cultures, thereafter. Data from the patients’ charts were retrospectively analyzed regarding the outcome of the procedures.

Results

Mean follow-up time was 52 months (47–60 months). VUR was cured in 47.4% of cases after a single injection. After the second injection the global success rate was 52.1%. Ureteroneocystostomy was performed on seven refluxing ureters of five children unresponsive to sub-ureteric injection therapy. One patient underwent nephroureterectomy because of a non-functioning kidney secondary to ureteral obstruction due to migration of material at the 23rd month postoperatively.

Conclusion

Although favorable short-term success rates have been reported with the sub-ureteric injection of calcium hydroxyapatite without any side effects, our long-term results showed a low success rate, with the only reported serious morbidity.

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Authors and Affiliations

  1. Department of Urology, Marmara University School of Medicine, Marmara University Hospital, Tophanelioglu Caddesi 13-15, Altunizade, Istanbul, 34662, Turkey

    Tufan Tarcan, Ilker Tinay, Yusuf Temiz & Ferruh Simşek

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  1. Tufan Tarcan
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  2. Ilker Tinay
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  3. Yusuf Temiz
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  4. Ferruh Simşek
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Correspondence to Tufan Tarcan.

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Tarcan, T., Tinay, I., Temiz, Y. et al. Long-term results of endoscopic treatment of vesicoureteral reflux with the sub-ureteric injection of calcium hydroxyapatite. Int Urol Nephrol 39, 1011–1014 (2007). https://doi.org/10.1007/s11255-007-9222-x

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  • DOI: https://doi.org/10.1007/s11255-007-9222-x

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