Endoscopic subureteral injection treatment with calcium hydroxylapatite in primary vesicoureteral reflux

Abstract

Introduction: In this study, we aimed to evaluate efficiency of subureteral injection of calcium hydroxylapatite treatment for primary vesicoureteral reflux (VUR).

Materials and methods: A total of 25 children (mean age 6.9 +/- 2.7 years) underwent subureteral injection of calcium hydroxylapatite for primary VUR. Reflux was present in 39 ureteral units that were unilateral in 11 cases and bilateral in 14 cases. According to "International Reflux Classification"; grade II in 12 (30.8%), grade III in 18 (46.2%) and grade IV in 9 (23.1%) ureteral units were found.

Results: The refluxes were resolved in 23 (59.0%) ureteral units after a single injection and 5 ureteral units (12.8%) after a second injection. Overall success rate of reflux treatment with calcium hydroxylapatite was 71.8% in all ureteral units.

Conclusion: Endoscopic subureteral injection of calcium hydroxylapatite in children with primary low-grade VUR appears to be an effective, safe and minimally invasive technique.