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  • Title: Bladder ultrasound in the evaluation of the efficacy of dextranomer/hyaluronic acid injection for treatment of vesicoureteral reflux.
    Author: Ozcan C, Ergün R, Ozbek SS, Avanoğlu A, Ulman I.
    Journal: J Clin Ultrasound; 2007 Sep; 35(7):357-62. PubMed ID: 17523192.
    Abstract:
    PURPOSE: To determine whether sonographic examination of subureteral implants after endoscopic dextranomer/hyaluronic acid (DHA) injection would help to evaluate the efficacy of this method in the treatment of vesicoureteral reflux. MATERIALS AND METHODS: Thirty-six patients (49 ureters) who underwent endoscopic subureteral DHA injection were evaluated using voiding cystourethrography (VCUG) and bladder sonography for a mean duration of 2.1 years (range, 3 months to 6.5 years) after treatment. Patient records-including the results of VCUG, renal sonography, Dimercapto succinic acid (DMSA) scintigraphy, and periodic urinary analysis-were also reviewed to determine the outcome of treatment. RESULTS: Reflux was corrected in 43/49 (88%) ureters (complete cure in 38, downgrading of reflux in 5). No change was noted in 6 (12%) ureters on VCUG. The reflux was found to be corrected in 19/22 (86%) ureters, with the implants clearly identifiable on sonography. However, reflux was documented in only 3/27 (11%) ureters, around which no implant was seen on sonography. CONCLUSION: The identification of the implant in the subureteral region by bladder sonography correlated with resolution of reflux in the early postinjection period. On the other hand, the majority of the implants disappeared on sonography in the long term despite correction of reflux. Therefore, we believe that the use of bladder sonography is not useful in the evaluation of patients in long-term follow-up.
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