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Advances in Urology
Volume 2011, Article ID 309626, 7 pages
Research Article

Endoscopic Bulking Materials for the Treatment of Vesicoureteral Reflux: A Review of Our 20 Years of Experience and Review of the Literature

1Department of Pediatric Urology, Shaare Zedek Medical Center, Faculty of Medical Science, Hebrew University, P.O. Box 3235, Jerusalem 91031, Israel
2Department of Urology, Bnai Zion Medical Center, 47 Golomb Street, Haifa 31048, Israel

Received 11 November 2010; Accepted 11 February 2011

Academic Editor: Eugene Minevich

Copyright © 2011 Boris Chertin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. We reviewed our 20 years of experience and the current literature regarding the long-term outcome of endoscopic treatment of vesicoureteric reflux (VUR) using the different tissue bulking substances with a special emphasis on the long-term efficacy. Material and Methods. Our own experience and the current literature on the long-term results after endoscopic treatment using various bulking agents were reviewed. Results. Short-term data following endoscopic treatment of VUR is similar to the various substances and comparable in the majority of the series to the success rate following open surgery. Recently, a relatively high recurrence rate was noticed especially with the use of dextranomer hyaluronic acid (Dx/HA) as a tissue augmenting material which raises the need for further search for alternative substances. Conclusions. Unfortunately, there is a significant shortage of evidence-based literature on the long-term followup after endoscopic correction of reflux with various substances. No doubt, there is a high recurrence rate during long-term followup after Dx/HA injection, and there is probably lack of proper evaluation regarding the long-term efficacy of other bulking materials. These facts demand long-term close observation and long-term studies beyond the routine protocols following endoscopic treatment of VUR and the correct parental counseling upon the endoscopic correction.