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(PP)
DOES AUTOLOGOUS BLOOD INJECTION FOLLOWING DEXTRANOMER
/HYALURONIC ACID IMPLANTATION IN TREATMENT OF VESICOURETERAL
REFLUX AFFECT THE IMMEDIATE AND EARLY MICROSPHERE PARTICLE LEAKAGE?
Sahar EFTEKHARZADEH
1
, Sarah MOZAFARPOUR
1
and Abdolmohammad KAJBAFZADEH
2
1) Tehran University of Medical Sciences, Pediatric Urology Research Center, Tehran, IRAN (ISLAMIC REPUBLIC OF) - 2)
Children's Hospital, Urology, Tehran, IRAN (ISLAMIC REPUBLIC OF)
PURPOSE
The aim of this study was to evaluate immediate and early dextranomer particle leakage following hydrodistention
autologous blood injection technique (HABIT) compared to hydrodistention injection technique (HIT).
MATERIAL AND METHODS
720 patients have received endoscopic implantation of dextranomer/hyaluronic acid co-polymer for VUR at our
institutions since 2008. A total of 53 (40 girls and 13 boys) of these patients, admitted from August 2014 till February
2015, were entered in the study. A subset of 37 patients underwent HABIT, while 16 children underwent HIT. Following
the completion of the procedure on each ureter ,bladder was drained 3 to 5 minutes ,then the bladder was irrigated for
several minutes and the retrieved sample of irrigation fluid was examined for dextranomer particle count and regarded
as "immediate leakage ". A Foley catheter was placed and the urine sample after 24 hours was also examined and
regarded as "Early leakage".
RESULTS
A total of 82 ureters were treated using HABIT (57) and HIT (25) techniques. Five cases were perforated and excluded
from final comparison. Immediate leakage was significantly higher in HIT group [Median (IQR): 536.2 (903)] compared
to HABIT group [Median (IQR): 25 (243)] (p=0.01). ). Early leakage in HIT group was higher than HABIT group,
however, it was not statistically significant (P=0.3).
CONCLUSIONS
This report represents evidence that use of autologous blood in endoscopic correction of VUR in children is associated
with significantly less dextranomer particle extravasation from the injection site. We suggest that this modification
further stabilizes the mound and prevents future possible migration.