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Endoscopic correction of vesicoureteral reflux (VUR) in children by subureteric injection of various tissue-augmenting substances since its introduction almost 35 years ago, becomes well accepted method of first-line interventional procedure to treat all grades of persisting reflux. However, its role in the management of high grade, i.e. grade IV and V reflux still is under debate [1,2,3,4]. A limited number of reports regarding results and efficacy of endoscopic management of high grade reflux is still available. Various bulking agents were used for this purpose: polytetrafluoroethylene (PTFE) before 2000, dextranomer/hyaluronic acid copolymer (Dx/HA, Deflux ®) since 2000 and recently polyacrylate-polyalcoholcopolymer (PPC, Vantris ®) [4,5,6,7,8,9,10,11,12]. PPC (Vantris ®) a synthetic, non-absorbable tissueaugmenting substance was introduced into clinical practice in 2010 [13] and is currently used in some centers Around the world [14, 15, 16, 17, 18, 19, 20].The aim of the present study was to evaluate the efficacy of PPC injection to correct reflux grade IV and V in children. Abstract

The Results of Endoscopic Treatment of Grade IV and V Persistent Vesiocoureteral Reflux in Children Using PolyacrylatePolyalcohol Copolymer (Vantris)