EFFECT OF TRANSURETHRAL COLLAGEN INJECTION FOR VESICOURETERAL REFLUX IN PATIENTS WITH SPINA BIFIDA

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  • 二分脊椎症例における膀胱尿管逆流症に対する経尿道的コラーゲン注入療法
  • 近接効果に関する検討

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Abstract

(Background) The effect of endoscopic injection of collagen was assessed in spina bifida patients with vesicoureteral reflux (VUR).<br>(Methods) Endoscopic collagen injection was carried out for grade II or worse VUR according to the international classification. Twenty-two ureters were studied in 6 boys and 8 girls (mean: 14.4 years) who were followed up over a period of at least 3 months (mean: 5 months) after surgery. they all had a negative preoperative skin test for collagen and were investigated radiologically and urody-namically. Cystograpy was performed 1, 3 and 12 months after surgery and thereafter once a year to detect recurrence of VUR.<br>(Results) Anesthesia was not necessary in 4 patients. No adverse reactions occured to the injection of collagen. VUR disappeared after 1 and 2 collagen injections in 17 (77%) and 2 (9%) ureters, respectively. The therapeutic effect of the single collagen injection showed no relationship to shape of the ureteral orifice, grade of VUR, compliance of the bladder, and presence of detrusor hyperreflexia.<br>(Conclusions) Endoscopic treatment of VUR with collagen injection in spina bifida patients is a simple and less invasive method. We obtained satisfactory short-term results by this method. However, since the risk factor of recurrence remains unclear, sufficient investigation of long-term results is important to determine the role of this method in the treatment of VUR in patients with spina bifida.

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