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Objectives <p>To compare long-term outcomes after endoscopic treatment of paediatric primary vesicoureteral reflux using a permanent polyacrylate-polyalcohol copolymer and a biodegradable dextranomer/hyaluronic acid agent.</p> Methods <p>This retrospective two-centre cohort study included 83 children treated over a two-year period and followed for six years. Forty-five children received polyacrylate-polyalcohol copolymer and 38 received dextranomer/hyaluronic acid. Outcomes included protocol-defined success, grade-specific success, reintervention, reintervention-free survival, postoperative urinary tract infection, obstruction, and direct material costs.</p> Results <p>Overall protocol-defined success was 68.9% with polyacrylate-polyalcohol copolymer and 63.2% with dextranomer/hyaluronic acid (<i>p</i> = 0.645). In grade IV reflux, success was higher with polyacrylate-polyalcohol copolymer (88.2% versus 50.0%; <i>p</i> = 0.017; odds ratio, 7.50). Reintervention was required in 13.3% and 36.8% of patients, respectively (<i>p</i> = 0.020; number needed to treat, 5). Reintervention-free survival at 60 months was 88.2% and 39.0%, respectively (log-rank <i>p</i> = 0.004). Documented urinary tract infection decreased significantly after treatment in the overall cohort (84.3% to 43.4%; <i>p</i> &lt; 0.001).</p> Conclusion <p>In this retrospective centre-linked cohort, polyacrylate-polyalcohol copolymer was associated with fewer reinterventions and more durable long-term reintervention-free survival than dextranomer/hyaluronic acid. The strongest efficacy signal was observed in grade IV reflux. Because treatment allocation was centre-linked and postoperative imaging protocols differed between centres, these findings should be interpreted as real-world cohort data rather than as definitive evidence of universal material superiority. Grade V reflux outcomes require particularly cautious interpretation.</p>

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Permanent versus Biodegradable Bulking Agents for Paediatric Vesicoureteral Reflux

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月30日

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  • Simona Zaťkuliaková,
  • Peter Bartoň,
  • Matúš Siváček,
  • Petra Ďubjaková,
  • Kristína Leiva Demetrová,
  • Jan Trachta,
  • Ján Breza Jr.

摘要

Objectives

To compare long-term outcomes after endoscopic treatment of paediatric primary vesicoureteral reflux using a permanent polyacrylate-polyalcohol copolymer and a biodegradable dextranomer/hyaluronic acid agent.

Methods

This retrospective two-centre cohort study included 83 children treated over a two-year period and followed for six years. Forty-five children received polyacrylate-polyalcohol copolymer and 38 received dextranomer/hyaluronic acid. Outcomes included protocol-defined success, grade-specific success, reintervention, reintervention-free survival, postoperative urinary tract infection, obstruction, and direct material costs.

Results

Overall protocol-defined success was 68.9% with polyacrylate-polyalcohol copolymer and 63.2% with dextranomer/hyaluronic acid (p = 0.645). In grade IV reflux, success was higher with polyacrylate-polyalcohol copolymer (88.2% versus 50.0%; p = 0.017; odds ratio, 7.50). Reintervention was required in 13.3% and 36.8% of patients, respectively (p = 0.020; number needed to treat, 5). Reintervention-free survival at 60 months was 88.2% and 39.0%, respectively (log-rank p = 0.004). Documented urinary tract infection decreased significantly after treatment in the overall cohort (84.3% to 43.4%; p < 0.001).

Conclusion

In this retrospective centre-linked cohort, polyacrylate-polyalcohol copolymer was associated with fewer reinterventions and more durable long-term reintervention-free survival than dextranomer/hyaluronic acid. The strongest efficacy signal was observed in grade IV reflux. Because treatment allocation was centre-linked and postoperative imaging protocols differed between centres, these findings should be interpreted as real-world cohort data rather than as definitive evidence of universal material superiority. Grade V reflux outcomes require particularly cautious interpretation.