Journal of Pediatric Urology
Volume 6, Issue 1 , Pages 15-22 , February 2010

The clinical utility and safety of the endoscopic treatment of vesicoureteral reflux in patients with duplex ureters

  • T.W. Hensle

      Affiliations

    • Children's Hospital of New York, 3959 Broadway, 219N, New York, NY 10032, USA
    • Columbia University, College of Physicians and Surgeons, Department of Urology, 161 Fort Washington Avenue, New York, NY 10032, USA
    • Corresponding Author InformationCorresponding author at: Children's Hospital of New York, 3959 Broadway, 219N, New York, NY 10032, USA. Tel.: +1 212 305 8510; fax: +1 212 305 4421.
  • ,
  • E.A. Reiley

      Affiliations

    • Hackensack University Medical Center, Department of Urology, 90 Prospect Avenue, Hackensack, NJ 07666, USA
  • ,
  • C. Ritch

      Affiliations

    • Columbia University, College of Physicians and Surgeons, Department of Urology, 161 Fort Washington Avenue, New York, NY 10032, USA
  • ,
  • A. Murphy

      Affiliations

    • Columbia University, College of Physicians and Surgeons, Department of Urology, 161 Fort Washington Avenue, New York, NY 10032, USA

Received 24 February 2009 ,Accepted 28 May 2009.

References 

  1. Elder JS, Peters CA, Arant BS, Ewalt DH, Hawtrey CE, Hurwitz RS, et al. Pediatric Reflux Vesicoureteral Guidelines Panel summary report on the management of primary vesicoureteral reflux in children. J Urol. 1997 May;157(5):1846–1851
  2. Elder JS. Guidelines for consideration for surgical repair of vesicoureteral reflux. Curr Opin Urol. 2000 November;10(6):579–585
  3. Afshar K, Papanikolaou F, Malek R, Bagli D, Pippi-Salle JL, Khoury A. Vesicoureteral reflux and complete ureteral duplication. Conservative or surgical management?. J Urol. 2005 May;173(5):1725–1727
  4. Elder JS. Imaging for vesicoureteral reflux – is there a better way?. J Urol. 2005 July;174(1):7–8
  5. Medical versus surgical treatment of primary vesicoureteral reflux: report of the International Reflux Study Committee. Pediatrics. 1981 March;67(3):392–400
  6. The management of primary vesicoureteral reflux in children. Baltimore, MD: American Urological Association; 1997;
  7. Elder JS, Diaz M, Caldamone AA, Cendron M, Greenfield S, Hurwitz R, et al. Endoscopic therapy for vesicoureteral reflux: a meta-analysis. I. Reflux resolution and urinary tract infection. J Urol. 2006 February;175(2):716–722
  8. Aaronson IA, Rames RA, Greene WB, Walsh LG, Hasal UA, Garen PD. Endoscopic treatment of reflux: migration of Teflon to the lungs and brain. Eur Urol. 1993;23(3):394–399
  9. Beisang AA, Ersek RA. Mammalian response to subdermal implantation of textured microimplants. Aesthetic Plast Surg. 1992;16(1):83–90
  10. Leonard MP, Canning DA, Peters CA, Gearhart JP, Jeffs RD. Endoscopic injection of glutaraldehyde cross-linked bovine dermal collagen for correction of vesicoureteral reflux. J Urol. 1991 January;145(1):115–119
  11. Reunanen M. Endoscopic collagen injection: its limits in correcting vesico-ureteral reflux in duplicated ureters. Eur Urol. 1997;31(2):243–245
  12. Lipski BA, Mitchell ME, Burns MW. Voiding dysfunction after bilateral extravesical ureteral reimplantation. J Urol. 1998 March;159(3):1019–1021
  13. Reunanen M. Correction of vesicoureteral reflux in children by endoscopic collagen injection: a prospective study. J Urol. 1995 December;154(6):2156–2158
  14. Q-Med AB. Deflux Package Insert (US) [Pamphlet]. Princeton, NJ: Q-MED AB; 2001;
  15. Stenberg A, Hensle TW, Lackgren G. Vesicoureteral reflux: a new treatment algorithm. Curr Urol Rep. 2002 April;3(2):107–114
  16. Berrocal T, Lopez-Pereira P, Arjonilla A, Gutierrez J. Anomalies of the distal ureter, bladder, and urethra in children: embryologic, radiologic, and pathologic features. Radiographics. 2002 September;22(5):1139–1164
  17. Hartman GW, Hodson CJ. The duplex kidney and related abnormalities. Clin Radiol. 1969 October;20(4):387–400
  18. Privett JT, Jeans WD, Roylance J. The incidence and importance of renal duplication. Clin Radiol. 1976 October;27(4):521–530
  19. Kaplan WE, Nasrallah P, King LR. Reflux in complete duplication in children. J Urol. 1978 August;120(2):220–222
  20. Bisset GS, Strife JL. The duplex collecting system in girls with urinary tract infection: prevalence and significance. AJR Am J Roentgenol. 1987 March;148(3):497–500
  21. Caldamone AA. Duplication anomalies of the upper tract in infants and children. Urol Clin North Am. 1985;12(1):75–91
  22. Amar AD. Reflux in duplicated ureters. Br J Urol. 1968 August;40(4):385–401
  23. Nordmark B. Double formations of the pelves of the kidneys and the ureters: embryology, occurrence, and clinical significance. Acta Radiol. 1948;30:267
  24. Fehrenbaker LG, Kelalis PP, Stickler GB. Vesicoureteral reflux and ureteral duplication in children. J Urol. 1972;107(5):862–864
  25. Amar AD, Chabra K. Reflex in duplicated ureters: treatment in children. J Pediatr Surg. 1970 August;5(4):419–430
  26. Calisti A, Marrocco G, Patti G. The role of minimal surgery with renal preservation in abnormal complete duplex systems. Pediatr Surg Int. 1999 July;15(5–6):347–349
  27. Husmann DA, Allen TD. Resolution of vesicoureteral reflux in completely duplicated systems: fact or fiction?. J Urol. 1991 May;145(5):1022–1023
  28. Aboutaleb H, Bolduc S, Khoury AE, Upadhyay J, Bagli DJ, Farhat W. Polydimethylsiloxane injection versus open surgery for the treatment of vesicoureteral reflux in complete duplex systems. J Urol. 2003 October;170(4 Pt 2):1563–1565
  29. Aboutaleb H, Bolduc S, Bagli DJ, Khoury AE. Correlation of vesicoureteral reflux with degree of hydronephrosis and the impact of antireflux surgery. J Urol. 2003;170(4 Pt 2):1560–1562
  30. Blake NS, O'Connell E. Endoscopic correction of vesico-ureteric reflux by subureteric Teflon injection: follow-up ultrasound and voiding cystography. Br J Radiol. 1989 May;62(737):443–446
  31. Dewan PA, O'Donnell B. Polytef paste injection of refluxing duplex ureters. Eur Urol. 1991;19(1):35–38
  32. Farkas A, Moriel EZ, Lupa S. Endoscopic correction of vesicoureteral reflux: our experience with 115 ureters. J Urol. 1990 August;144(2 Pt 2):534–536
  33. Geiss S, Alessandrini P, Allouch G, Aubert D, Bayard M, Bondonny JM, et al. Multicenter survey of endoscopic treatment of vesicoureteral reflux in children. Eur Urol. 1990;17(4):328–329
  34. Kumar R, Puri P. Newly diagnosed contralateral reflux after successful unilateral endoscopic correction: is it due to the pop-off mechanism?. J Urol. 1997 September;158(3 Pt 2):1213–1215
  35. Puri P, O'Donnell B. Endoscopic correction of grades IV and V primary vesicoureteric reflux: six to 30 month follow-up in 42 ureters. J Pediatr Surg. 1987 December;22(12):1087–1091
  36. Lackgren G, Wahlin N, Skoldenberg E, Neveus T, Stenberg A. Endoscopic treatment of vesicoureteral reflux with dextranomer/hyaluronic acid copolymer is effective in either double ureters or a small kidney. J Urol. 2003 October;170(4 Pt 2):1551–1555
  37. Miyakita H, Ninan GK, Puri P. Endoscopic correction of vesico-ureteric reflux in duplex systems. Eur Urol. 1993;24(1):111–115
  38. Perez-Brayfield M, Kirsch AJ, Hensle TW, Koyle MA, Furness P, Scherz HC. Endoscopic treatment with dextranomer/hyaluronic acid for complex cases of vesicoureteral reflux. J Urol. 2004 October;172(4 Pt 2):1614–1616
  39. Schulman CC, Pamart D, Hall M, Janssen F, Avni FE. Vesicoureteral reflux in children: endoscopic treatment. Eur Urol. 1990;17(4):314–317
  40. Steinbrecher HA, Edwards B, Malone PS. The STING in the refluxing duplex system. Br J Urol. 1995 August;76(2):165–168
  41. Leonard MP, Decter A, Mix LW, Johnson HW, Coleman GU. Endoscopic treatment of vesicoureteral reflux with collagen: preliminary report and cost analysis. J Urol. 1996 May;155(5):1716–1720
  42. Merckx L, De BV, Braeckman J, Verboven M, Piepsz A, Keuppens F. Endoscopic submucosal Teflon injection (STING): an alternative treatment of vesicoureteric reflux in children. Eur J Pediatr Surg. 1995 February;5(1):34–36
  43. Q-Med AB. US Package Insert for Deflux [gel of dextranomer microspheres (50mg/mL) in a carrier gel of non-animal stabilized hyaluronic acid (17mg/mL); pamphlet]. 2007.
  44. Stenberg A, Lackgren G. A new bioimplant for the endoscopic treatment of vesicoureteral reflux: experimental and short-term clinical results. J Urol. 1995 August;154(2 Pt 2):800–803
  45. Sauvage P, Geiss S, Saussine C, Laustriat S, Becmeur F, Bientz F, et al. Analysis and perspectives of endoscopic treatment of vesicoureteral reflux in children with a 20-month follow-up. Eur Urol. 1990;17(4):310–313
  46. Mascatello VJ, Smith EH, Carrera GF, Berger M, Teele RL. Ultrasonic evaluation of the obstructed duplex kidney. AJR Am J Roentgenol. 1977 July;129(1):113–120
  47. Inamoto K, Tanaka S, Takemura K, Ikoma F. Duplication of the renal pelvis and ureter: associated anomalies and pathological conditions. Radiat Med. 1996;1(1):55–64
  48. Peng HC, Chen HC. Surgical management of complete ureteric duplication abnormalities in children. Zhonghua Yi Xue Za Zhi (Taipei). 2000 March;63(3):182–188
  49. Wille S, von Knobloch R, Klose KJ, Heidenreich A, Hofmann R. Magnetic resonance urography in pediatric urology. Scand J Urol Nephrol. 2003;37(1):16–21
  50. Yanagisawa N, Yajima M, Takahara T, Nosaka S, Iwamoto T. Diagnostic magnetic resonance-urography in an infant girl with an ectopic ureter associated with a poorly functioning segment of a duplicated collecting system. Int J Urol. 1997 May;4(3):314–317
  51. Avni FE, Nicaise N, Hall M, Janssens F, Collier F, Matos C, et al. The role of MR imaging for the assessment of complicated duplex kidneys in children: preliminary report. Pediatr Radiol. 2001 April;31(4):215–223
  52. Weinstein AJ, Bauer SB, Retik AB, Mandell J, Colodny AH. The surgical management of megaureters in duplex systems: the efficacy of ureteral tapering and common sheath reimplantation. J Urol. 1988 February;139(2):328–331
  53. Winters WD, Lebowitz RL. Importance of prenatal detection of hydronephrosis of the upper pole. AJR Am J Roentgenol. 1990 July;155(1):125–129
  54. Share JC, Lebowitz RL. The unsuspected double collecting system on imaging studies and at cystoscopy. AJR Am J Roentgenol. 1990 September;155(3):561–564
  55. Lam AH, Sachinwalla TN. Imaging of ureteral duplication with a non-functioning component. Australas Radiol. 1990 February;34(1):64–67
  56. Bellah RD, Long FR, Canning DA. Ureterocele eversion with vesicoureteral reflux in duplex kidneys: findings at voiding cystourethrography. AJR Am J Roentgenol. 1995 August;165(2):409–413
  57. Lopes JF, Cendron M, Ellsworth PI. Cystoscopy at the time of ureteral reimplantation for primary vesicoureteral reflux: is it necessary? Incidence of undetected anomalies and cost. Urology. 2001 June;57(6):1156–1158
  58. Bhide A, Sairam S, Farrugia MK, Boddy SA, Thilaganathan B. The sensitivity of antenatal ultrasound for predicting renal tract surgery in early childhood. Ultrasound Obstet Gynecol. 2005 May;25(5):489–492
  59. Giorgi LJ, Bratslavsky G, Kogan BA. Febrile urinary tract infections in infants: renal ultrasound remains necessary. J Urol. 2005 February;173(2):568–570
  60. Peppas DS, Skoog SJ, Canning DA, Belman AB. Nonsurgical management of primary vesicoureteral reflux in complete ureteral duplication: is it justified?. J Urol. 1991 December;146(6):1594–1595
  61. Puri P, Chertin B, Velayudham M, Dass L, Colhoun E. Treatment of vesicoureteral reflux by endoscopic injection of dextranomer/hyaluronic acid copolymer: preliminary results. J Urol. 2003 October;170(4 Pt 2):1541–1544
  62. Routh JC, Vandersteen DR, Pfefferle H, Wolpert JJ, Reinberg Y. Single center experience with endoscopic management of vesicoureteral reflux in children. J Urol. 2006;175(5):1889–1892
  63. Altug U, Cakan M, Yilmaz S, Yalinkaya F. Are there predictive factors for the outcome of endoscopic treatment of grade III–V vesicoureteral reflux with dextranomer/hyaluronic acid inchildren?. Pediatr Surg Int. 2007;23(6):585–589
  64. Puri P, Pirker M, Mohanan N, Dawrant M, Dass L, Colhoun E. Subureteral dextranomer hyaluronic acid injection as first line treatment in the management of high grade vesicoureteral reflux. J Urol. 2006;176(4 pt 2):1856–1859
  65. Dawrant MJ, Monanan N, Puri P. Endoscopic treatment for high grade vesicoureteral reflux. J Urol. 2006;176(4 pt 2):1847–1850
  66. Puri P, Mohanan N, Menezes M, Colhoun E. Endoscopic treatment of moderate and high grade vesicoureteral reflux in infants using dextranomer/hyaluronic acid. J Urol. 2007;1784(4 pt 2):1714–1716
  67. Yucel S, Gupta A, Snodgrass W. Multivariate analysis of factors predicting success with dextranomer/hyaluronic acid injection for vesicoureteral reflux. J Urol. 2007;177(4):1505–1509

PII: S1477-5131(09)00359-3

doi: 10.1016/j.jpurol.2009.05.015

Journal of Pediatric Urology
Volume 6, Issue 1 , Pages 15-22 , February 2010