Summary
Introduction
There are various treatment options for symptomatic bladder diverticulum, including
robotic-assisted laparoscopic bladder diverticulectomy, open and endoscopic techniques.
But, to date, the optimal surgical technique remains unclear.
Objective
To present the preliminary long-term follow-up results of a novel technique of dextranomer/hyaluronic
acid copolymer (Deflux) plus autologous blood injection for correction of hutch diverticulum
in patients with concomitant vesicoureteral reflux (VUR).
Patient and method
We retrospectively reviewed four patients who had hutch diverticulum with concomitant
VUR and had undergone submucosal Deflux following autologous blood injection. Patients
with neurogenic bladder, posterior urethral valve, or voiding dysfunction were excluded
from the study. Success was defined as the resolution of the diverticulum, hydronephrosis,
and hydroureter on ultrasonography at a 3-month follow-up and long-term symptom-free
period.
Results
Four patients with hutch diverticula were included. The median age at the time of
surgery was 6.1 (range 3–8) years. Three of them had unilateral VUR, and one had bilateral
VUR. During the procedure, a mean of 0.625 ml Deflux plus a mean of 1.25 ml autologous
blood were injected submucosally for correction of VUR. Additionally, a mean of 1.62 ml
Deflux plus a mean of 1.75 ml autologous blood were injected submucosally to occlude
the diverticulum. The median follow-up was 4.6 (range 4–8) years. This method had
excellent success in all patients in the current study with no postoperative complications
such as febrile urinary tract infection, or diverticulum, hydroureter, or hydronephrosis
in follow-up ultrasounds.
Conclusions
Graphical Abstract
Keywords
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Article info
Publication history
Published online: February 26, 2023
Accepted:
February 21,
2023
Received in revised form:
February 3,
2023
Received:
August 31,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
