SUBURETERAL MUCOSA INJECTION WITH DETRANOMER/HYALURONIC ACID FOR VESICOURETERAL REFLUX TREATMENT: SYSTEMATIC REVIEW
Abstract: The aim of this
study is to search the success rate of detranomer-hyaluronic acid (Dx/HA) used
as injection through endoscopy approach and grades of vesicoureteral reflux
(VUR) that could affect it success rate. Material & methods: We searched
the literatures from MEDLINE database and PubMed from year 2001 until 2013. The
data was analyzed using Random Effects Model with the method of Mantzel-Haenzel
to analyze the success rates of dextranomer/hyaluronic acid and was determined
by 95% Confidence of Interval (CI) disclosure. Meta-regression was performed to
adjust the success rate compared with the grade of VUR as covariate. We
assessed the heterogeneity by calculating the I2 statistic. All analyses were
performed with Stata Statistical Software Version 12.0 (StataCorp). Results: We
identified 9 literatures in full review. Of 1105 ureters that were injected
with dextranomer/hyaluronic acid, 817 (72%; CI: 67-76%) were successfully
treated according to author’s definition. The success rates of Dx/HA for
pediatric with grade 1 VUR reached 80% (95% CI: 66-89%), whereas in grade 5 VUR
only 50% (95% CI: 34-66%; p<0.05). Conclusion: The overall success rate of
dextranomer/hyaluronic acid injection treatment was 72% after 3 months,
although success rates varied widely among studies. Preoperative grade of VUR
was significantly associated with treatment outcome. Increased VUR grade
negatively affected success rates.
Keywords: Vesicoureteral
reflux; subureteral mucosa injection; dextranomer/hyaluronic acid; systematic
review
Author: Nicholas Tambunan,
Arry Rodjani, Irfan Wahyudi
Journal Code: jpkedokterangg170016
