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    Prospective Evaluation of the Efficacy of Subureteral Injection in the Management of Vesicoureteral Reflux
    (Düzce Üniversitesi, 2007) Çam, H Kamil; Kayıkçı, M Ali; Akman, R Yavuz
    Endoscopic subureteral injection constitutes a valuable treatment option in the surgical management of vesicoureteral reflux (VUR). Recently, it regains popularity as it has been proposed an alternative to conservative management of VUR. The objective of the current study was to prospectively evaluate the efficiency of subueretal dextranomer in jection in VUR. Twenty-two patients (27 renal units) with vesicoureteral reflux scheduled for endoscopic treatment were included in the study. Secondary reflux cases were excluded. Of the patients included in the study, grade II reflux in 5 units (bilateral reflux in two cases), grade III reflux in 19 renal units (bilateral reflux in 3), grade IV reflux in 3 units were noted. Dextranomer (deflux) was used in all the cases as bulking agent. Injection needle was introduced at six o’clock position at the ureteral orifice and further moved for 0.8 cm before injection. Injection was continued until volcanic appearance of the orifice was obtained. Success was defined as no reflux in the voiding cystourethrography obtained 3 months after the operation. Postoperative control cystourethrography showed no reflux in 22 renal units of 27 (81%), the success was 77% (17/22) when the number of the patients taken into consideration. Grade II, grade III, and grade IV refluxes resolved in 80% (4/5 renal units), 84% (16/19 renal units), 66% (2/3 renal units) respectively. We concluded that endoscopic suburethral dextranomer treatment has high success rates in the treatment of VUR for properly selected cases