Journal of Nippon Medical School: Vol.67 No.1 page.009

Journal of Nippon Medical School

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ArticleTitle Endoscopic treatment of vesicoureteral reflux in children with glutaraldehyde cross-linked bovine dermal collagen Short-term results

AuthorList Narumi Tsuboi¹, Kazutaka Horiuchi¹, Shuichi Osawa¹, Tsutomu Hamasaki¹, Junko Yoshida², Mutsumi Murakami² and Masao Akimoto¹

Affiliation ¹Department of Urology and ²Department of Pediatrics, Nippon Medical School

Language EN

Volume 67

Issue 1

Year 2000

Page 9-12

Received

Accepted

Keywords VUR, endoscopic treatment, GAX collagen

Abstract Background: Endoscopic treatment using glutaraldehyde cross-linked (GAX) collagen was conducted on 4 children with bilateral primary vesicoureteral reflux (VUR) ...a 1-year-old boy and three 5- to 8-year-old girls...all having a history of repeated hospitalization for fever due to acute pyelonephritis, visiting as pediatric outpatients regularly and receiving antibiotics continuously. By international VUR classification, 4 ureters were grade 3, 2 grade 4, and 2 grade 5. Methods: After nonallergy to GAX collagen was confirmed intracutaneously, a needle was used through a 9.5 Fr cystoscope channel to puncture bladder mucosa 4 to 5 mm from the affected ureteral orifice at 6 o'clock under general anesthesia; 1.1 to 1.9 ml of GAX collagen was injected immediately below affected orifices. Results: Three months after surgery, voiding cystourethrography showed reflux had disappeared in 6 ureters, for a short-term success rate of 75% . VUR in the Remaining 2 ureters improved from grade 3 to 1 and from grade 5 to 4. No postoperative urinary tract infection occurred and antibiotics were stopped. Conclusion: Since GAX collagen is less viscous than Teflon paste, it is easily injected into submucosa, does not form granuloma or migrate to other organs, and is noncarcinogenic. Endoscopic VUR treatment using GAX collagen is indicated when less invasion and shorter hospitalization are considered, although it requires general anesthesia, which itself involves some risk.

Correspondence to

ArticleTitle	Endoscopic treatment of vesicoureteral reflux in children with glutaraldehyde cross-linked bovine dermal collagen Short-term results
AuthorList	Narumi Tsuboi¹, Kazutaka Horiuchi¹, Shuichi Osawa¹, Tsutomu Hamasaki¹, Junko Yoshida², Mutsumi Murakami² and Masao Akimoto¹
Affiliation	¹Department of Urology and ²Department of Pediatrics, Nippon Medical School
Language	EN
Volume	67
Issue	1
Year	2000
Page	9-12
Received
Accepted
Keywords	VUR, endoscopic treatment, GAX collagen
Abstract	Background: Endoscopic treatment using glutaraldehyde cross-linked (GAX) collagen was conducted on 4 children with bilateral primary vesicoureteral reflux (VUR) ...a 1-year-old boy and three 5- to 8-year-old girls...all having a history of repeated hospitalization for fever due to acute pyelonephritis, visiting as pediatric outpatients regularly and receiving antibiotics continuously. By international VUR classification, 4 ureters were grade 3, 2 grade 4, and 2 grade 5. Methods: After nonallergy to GAX collagen was confirmed intracutaneously, a needle was used through a 9.5 Fr cystoscope channel to puncture bladder mucosa 4 to 5 mm from the affected ureteral orifice at 6 o'clock under general anesthesia; 1.1 to 1.9 ml of GAX collagen was injected immediately below affected orifices. Results: Three months after surgery, voiding cystourethrography showed reflux had disappeared in 6 ureters, for a short-term success rate of 75% . VUR in the Remaining 2 ureters improved from grade 3 to 1 and from grade 5 to 4. No postoperative urinary tract infection occurred and antibiotics were stopped. Conclusion: Since GAX collagen is less viscous than Teflon paste, it is easily injected into submucosa, does not form granuloma or migrate to other organs, and is noncarcinogenic. Endoscopic VUR treatment using GAX collagen is indicated when less invasion and shorter hospitalization are considered, although it requires general anesthesia, which itself involves some risk.
Correspondence to