Comperative evaluation of subureteric injection materials efficiency in vesicoreteral reflux treatment; dextranomer hyaluronic acid vs polyacrylate polyalcohol copolymer

Vesicoureteral reflux (VUR) is one of the most frequent avoidable cause of end stage renal failure. Palliative medical treatment, endoscopic and open surgery technics can be applied on suitable patients. In this study, we aimed to compare the efficiency of Dextranomer Hyaluronic acid (DxHA) (Urodex®, Dexell®) and polyacrylate polyalcohol copolymer (PPC) (Vantris®) in VUR patients. Sixty nine patients (100 renal refluxive unit) randomized into two groups. Mean age was 8.4 in DxHA group and 5.4 in PPC. Each group has 50 renal refluxive unit (DxHA groupboys:17 girls:33, PPC group boys:21 girls:29). VUR grades of renal refluxive units in DxHA and PPC groups were 2 and 3 RRU grade I, 7 and 5 RRU grade II, 18 and 14 RRU grade III, 13 and 14 RRU grade IV, 10 and 14 RRU grade V respectively. 39 RRU in DxHA group and 36 RRU in PPC group was the first injection for VUR treatment. Complete resolution rate of VUR was %32 in DxHA group and %56 in PPC group (p=0.016) and grade regression rate was %61 and %82 (p=0.027) respectively. In seconder cases VUR resolution reported in 5 and 7 RRU in DxHA and PPC groups respectively. The results show us generally PPC has better results due to DxHA at the endoscopic treatment of VUR enough to generate statistically significant differences between them. Although PPC results are superior than DxHA results, further and long term studies should performed to show better results. Keywords: Vesicoureteral reflux, dextranomer hyaluronic acis, polyacrylate polyalcohol copolymer.