Efficacy and Safety of Polyacrylate Polyalcohol Co-polymer (Vantris) Injection Material in the Endoscopic Treatment of VUR in Children: 3 Years of Prospective Follow Up

BACKGROUND:
To evaluate the safety, efficacy and durability of Vantris injection over a period of 3 years.
PATIENTS AND METHOD:
From 2015 to 2018 we followed 40 patients {male 14, female 26} with a mean age of 4.2±3.4 years (mean ± SD) underwent endoscopic Vantris injection therapy for treatment of primary vesicoureteral prospectively by voiding cystourethrogram at 3months, 1 year and 3 years. Those 40 patients comprising 70 refluxing renal unit (RRU), were unilateral in 10 patients and bilateral in 30 patients. Those were grade II in 10 RRU, grade III in 35 RRU and grade IV in 25 RRU. The volume of injected Vantris material was 0.8ml (range 0.4-1.2 ml) per refluxing unit. The patients were followed. Ultrasound was used at 1 week, 1 month and yearly for 3 years.
RESULTS:
All patients completed 3 years follow up by voiding cystourethrogram. At 3months VCUG 1 was done and shows: 10/10 RRU of grade II, 32/35 RRU of grade III and 23/25 RRU of grade IV show complete resolution of reflux, Success rate is 92.85%. At 1year VCUG 2 was done and shows: 10/10 RRU of grade II, 32/32 of grade III and 21/23 of grade IV show complete resolution of reflux, Success rate is 96.92%. At 3years VCUG 3 was done and shows: 10/10 RRU of grade II, 32/32 of grade III and 21/21 of grade IV show complete resolution of reflux, Success rate is 100%. The overall success rate is 63/70 (90%).
CONCLUSION:
Endoscopic injection of Vantris material for treatment of vesicoureteral reflux in children is very effective, safe and durable, and can be considered as first line treatment of grade Ⅱ-Ⅳ vesicoureteral reflux.

Keywords

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