ESPU Congress 2018 - Abstract Book

52 29 th CONGRESS OF THE ESPU 08:37–08:40 S4-4 (PP) IF THERE IS AN INCREASE IN UVJ OBSTRUCTION DURING LONG TERM FOLLOW AFTER ENDOSCOPIC CORRECTION OF VUR UTILIZING VANTRIS? Stanislav KOCHEROV  1 , Sergey NIKOLAEV  2 , Jaber JAWDAT  1 , Ludmila MENOVSHCHIKOVA  2 , Semen KOVARSKIY  2 , Tatiana SKLIAROVA  2 and Boris CHERTIN  3 1) Shaare Zedek Medical Center, Pediatric Urology, Jerusalem, ISRAEL - 2) Filatov Pediatric Hospital, Pediatric Urology, Moscow, RUSSIAN FEDERATION - 3) Shaare Zedek Medical Center, Pediatric Urology, Jerusalem, ISRAEL PURPOSE We present a long-term follow-up of patients who underwent VUR correction with Vantris injection with an emphasis on UVJ obstruction and urinary tract infection. MATERIAL AND METHODS During 2009–2012, 157children (106 girls and 51 boys) with mean age of 4.8 ± 2.8 years (mean ± SD) underwent endoscopic correction of VUR using Vantris. VUR was unilateral in 74 patients and bilateral in 83 comprising 240 renal reflux units (RRU). Of these, primary VUR was present in 197 RRU (82.1 %) and 43 (17.9 %) were complex cases. 126 (80.3 %) had Breakthrough febrile UTI and in 32 (19.7 %) patients reflux was diagnosed due to antenatal hydronephrosis. Median follow-up was 6 years (range 5–8 years). RESULTS Reflux was corrected in 222 RRU (92.5 %) after a single injection, after the second injection in 10 RRU (4.2 %). In RRU 7 (2.9 %), reflux downgraded to Grade I and II, and they were taken off antibiotic prophylaxis. One patient (0.4 %) failed endoscopic correction and required ureteral reimplantation (UR). 11 (4.6 %) RRU developed UVJ obstruction, of which 9 (3.8 %) required UR. In these patients reflux was Grade III in 1 RRU, Grade IV in 3 and V in 3 RRU respectively. All patients developed obstruction between one to two years after injection. All these ureters were injected with an average of 1.2 ml (0.6–1.8) of Vantris. 19 (12.1 %) patients developed low UTI, and 12 (7.6 %) patients developed febrile UTI during follow up. None of these patients had reflux recurrence. CONCLUSIONS Our data indicate that endoscopic correction utilizing Vantris does not increase the risk of obstruc- tion during long term follow up and significantly reduces the risk of acute pyelonephritis after suc- cessful repair. However, the use of Vantris in patients with high-grade reflux and the injection of a large amount of material might lead to the increased incidence of UVJ obstruction and need in subsequent UR.