Gel Injection for VUR is Highly Effective Treatment

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					                                                                                FEBRUARY 2010      Renal & Urology News 29

Gel Injection for VUR is Highly Effective Treatment
ENDOSCOPIC injection of non-animal-        this approach by a single surgeon at     undergo a VCUG, leaving an efficacy        after a single treatment, according to
stabilized hyaluronic acid/dextranomer     the Baylor College of Medicine in        population of 166 patients. In this       a report in Urology (2009; published
gel (HA/Dx) is a highly effective treat-   Houston. At least two after treat-       group, the surgeon, Michael H. Hsieh,     online ahead of print). After a second
ment for vesicoureteral reflux (VUR) in     ment, patients were to return for a      MD, PhD, who is now at Stanford           treatment, the proportions increased
children and should be considered as a     voiding cystourethrogram (VCUG)          School of Medicine in Stanford, Calif.,   to 89.6% and 95.6%, respectively.
first-line treatment option.                assessment.                              treated 265 ureters (252 refluxing and     After a third treatment, the propor-
  Researchers studied 178 children with      After initial treatment, 12 patients   13 non-refluxing). Reflux resolved in       tions rose slightly to 90.2% and 96%.
VUR (mean age 4.2 years) treated with      were lost to follow-up or had yet to     81.9% of subjects and 86.4% of ureters    The procedures were associated with
                                                                                                                              few complications.
                                                                                                                                HA/Dx gel became the first material
                                                                                                                              approved by the FDA for endoscopic
                                                                                                                              injection in children with grade 2-4 VUR,
                                                                                                                              the authors noted. Endoscopic injection
                                                                                                                              of the gel usually is performed on an
                                                                                                                              outpatient basis. It requires no incision
                                                                                                                              and can be performed quickly. ■

                                                                                                                               Lead May
                                                                                                                               Have a Role
                                                                                                                               In Bladder
                                                                                                                               LEAD EXPOSURE may be associated
                                                                                                                               with the initiation and development of
                                                                                                                               bladder cancer, according to a study
                                                                                                                               conducted in Poland.
                                                                                                                                 A team led by Tomasz Golabek, MD,
                                                                                                                               now with Mercy University Hospital in
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