ENDOSCOPIC TREATMENT OF VESCICOURETERAL REFLUX IN ADULT PATIENTS: SUSPENSION TECNIQUE WITH VANTRIS
Abstract
The aim of this video is to describe an injection technique with polyacrylate polyalcohol copolymer (PPC, Vantris, Promedon, Cordoba, Argentina) using a guidewire to suspend the anterior wall of the ureter and show our results comparing them with the classic STING technique first described by O’Donnel and Kirsh.
Between 2013 and 2017 we performed 19 endoscopic bulking procedures in women with vescicoureteral reflux. We retrospectively compared the use of the classic STING technique and the suspension technique in terms of success rate.
The clinical case describes the treatment of VUR in a 48 years old woman with bilateral endoscopic injection of Vantris.
7 patients underwent the classic STING approach, 12 the suspension. Table 1 reports the results in terms of number of injections needed to achieve the correction of VUR. Success rate after 1 injection is 91.6% in the suspension group and 57.1% in the STING group.
This tecnique improves the efficacy of endoscopic treatment of VUR. Our preliminary experience with a small population and fourther studies with this tecnique must be encouraged to improve the correct and otherwise difficult treatment of VUR in adult patients.
Table 1
Tecnique Correction after 1 injection Correction after 2 injections Failure Tot.
STING 4 2 1 7
SUSPENSION 11 1 0 12