Endoscopic Treatment of Vesicoureteral Reflux with Collagen: Preliminary Report and Cost Analysis |
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Authors: | Michael P. Leonard Allan Decter Lawrence W. Mix Hjalmar W. Johnson Gerald U. Coleman |
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Affiliation: | University of Manitoba, Winnipeg, Manitoba, University of Alberta, Edmonton, Alberta and University of British Columbia, Vancouver, British Columbia, Canada. |
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Abstract: | PurposeWe determined therapeutic and operative cost efficacy of endoscopic collagen injection for vesicoureteral reflux.Materials and MethodsWe performed a multicenter study of 10 male and 23 female sequential patients (45 renal units) with vesicoureteral reflux and a surgical indication. Patients were skin tested with collagen and when negative, they underwent endoscopic injection. Renal ultrasound/ cystography was done 3 months after treatment. Cost analysis was performed at 1 institution.ResultsReflux was grade I in 2 renal units, II in 18, III in 15 and IV in 10. The majority of cases were single systems with primary reflux. We performed 1 treatment in 32 renal units, 2 in 6, 3 in 6 and 4 in 1. Cure was evident in 31 of 38 renal units (81.6 percent) and 21 of 27 patients (78 percent) 3 months after the last injection. Patient morbidity was minimal. Operative cost per renal unit was $1,599.68 for collagen injection and $9,144.47 for reimplantation.ConclusionsEndoscopic injection of collagen is effective treatment for vesicoureteral reflux. Furthermore, it causes minimal morbidity and may effect cost savings in health care management. |
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