Tratamiento endoscópico del reflujo de vesicoureteral en pediatría: Experiencia preliminar con la inyección subureteral de coaptite®

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Abstract
To review our experience in the endoscopic treatment of vesicoureteral reflux (VUR) in children with the subureteral injection of calcium hydroxyapatite (Coaptite). The serie includes thirteen children whose age ranged between 6 and 13 years. The Coaptite implant was injected subureterally to 20 ureteral units (UU) affected by VUR grades I-IV. VUR was unilateral in six patients (46%), bilateral in seven (54%). There were 7 primary cases and 6 secondary to bladder dysfunction and duplex systems. Mean follow-up was 19 months (6-28 months). VUR was cured in 75% of cases after a single injection. A second injection resolved 2 out of 4 treated UU (50%) rendering a global success rate of 85%. This cure rate was achieved for 13 and 7 procedures treating primary and secondary VUR, respectively. 77% of patients reported no adverse events with only 23% of them complaining of transient mild lumbar and hypogastric discomfort limited to the first postoperative day. In 2 children postoperative urinary infection was detected. Endoscopic subureteral injection with Coaptite is a simple technique well tolerated in children. In 85% of primary and secondary cases cure was achieved with minimal morbidity.

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