Table 2.
Outcomes of single endoscopic injection with DHA
| LOE | Study | Year | Patients/ureters | Pre-op VUR grade | Success ratea | Last VCUG years after Tx | Patients/ureters w/late VCUG | Recurrent VUR No ureters (%)b | Febrile UTI No patients (%) | NF-UTI No patients (%) |
|---|---|---|---|---|---|---|---|---|---|---|
| 1b | Läckgren [47] | 2001 | 221/334 | 3–5 | 54%* | 2–5 | 49/77 | 13 (17%) G3-4 | 8/221 (3.5%) | 11/221 (4.8%) |
| 20 (26%) G2-4 | ||||||||||
| 1b | Oswald [48] | 2002 | 38/56 | 2–4 | 71.4%* | 1 | 22/32 | 10 (31.2%) | – | – |
| 62.5%** | ||||||||||
| 2b | Kirsch [60] | 2003 | 180ζ/292 | 1–4 | 72%** | – | – | – | – | – |
| 1a | Elderc [44], [60] | 2006 | 5,527/8,101 | 1–5 | 75.7%*** | – | – | – | 0.75% | 6% |
| 2b | Lee [49] | 2009 | 219/337 | 1–5 | 73%** | 1 | −/150 | 39 (26%) | – | – |
| 2b | Chertin [54] | 2009 | 507/696 PTFE or DHA | 1–5 | 68%** | 1–12 | 11/- | 8 (72.7%)ψ (3 DHA) | 11/507 (2.2%) (3 DHA) | 28/507 (5.6%) |
| 2b | Hsieh [50] | 2010 | 166/265 | 1–5 | 86.4%** | 1 | 44/- | – | 0/44 (0%) | 11/44 (25%) |
| 1b | Holmdahl [46] | 2010 | 66/82 | 3–4 | 54.5%* | 2 | 52/63 | 30 (47.6%) G2-4 | 14/66 (21%) | – |
| Brandström [51] | 52%** | 66/- | 13 (20%)ψ G3-4 | |||||||
| 2a | Routh [45] | 2010 | −/7,303 | 1–5 | 77%*** | – | – | – | – | – |
aAll reported as per-ureter success rate following single injection except Läckgren and Kirsch (per-patient success rate)
bAll reported as per ureter recurrence rate except Chertin and Holmdahl (per-patient recurrence rate)
cAnalysis includes studies using non-DHA bulking agents
LOE Level of evidence; NF Non-febrile
*Success ≤ grade 1 reflux
**Success = no reflux
***Success varies with each author’s definition
ψPer-patient recurrence rate
ζ134 patients had 3-month follow-up and were included in analysis