Abstract:
Purpose. Recently published date on high recurrence rate following successful treatment of VUR has
prompted the search for different injectable substances with non- biodegradable nature. We have evaluated
an outcome of endoscopic correction VUR utilizing Vantris as a new non- biodegradable tissue-augmentinq
substance in stady.
Material and methods. From 2011 to 2016 331 patientes (117 boys and 214 girls) with a mean age of 3.56
years (range 8m – 14 years) were treated with Vantris. VUR was unilateral in 219 and bilateral 112 patients comprising 443 renal refluxing units (RRU).Of these, primary VUR was present in 371(86%) RRU and 72(14%) were
complex cases. Reflux was grades 1 to IV 68(15,3%), 266 (60%) and 109(24,6%) RRU respectively. Patients were
monitored with US at 1, 3, 6 and 12 months, and 2 and 3 years VCUG - 1 and 2 years.
Results. Reflux resolved in 411 RRU (92, 8%) after first injection, in 9 ( 2% ) after second and in 2 (0,45%)
after third injection respectively. VUR improved to grade 1 in 16 ( 3,6% ) ureters, which needed no further treatment. Injection failed to correct reflux in 3 (0, 7 %), which were then treated with ureteral reimplantation. None
showed VUR recurrence. US demonstrated normal appearance of kidneys in all but 15 (3,2 %) patients.VUJ obstructions requiring ureteral reimplantation developed in 2 ( 0,47%) ureters. Two (0, 47%) RRU requiring stent
insertion due to deterioration ureterohydronephrosis resulted in complete resolution of obstruction. Seventeen
(5% ) patients suffered afebrile and 2 (0,6%) developed febrile UTI. None demonsrated VUR recurrens.
Conclussion. The results of this survey confirm that endoscopic subureteral Vantris injection is a simple,safe,and effective outpatient procedure for treating VUR in patients over 2-3 years.
