Author/Editor		Kmetec, A; Kaplan-Pavlovčič, S; Bren, AF
Title		Endoskopsko zdravljenje vezikoureteralnega refluksa s kolagenom pri presajeni ledvici
Translated title		Vesicoureteral reflux after kidney transplantation: endoscopic treatment with collagen
Type		članek
Source		In: Buturović-Ponikvar J, Bren AF, editors. Zbornik 2. slovenski nefrološki kongres z mednarodno udeležbo ob 30. letnici dialize in transplantacije ledvic v Sloveniji; 2000 sep 27-30; Brdo pri Kranju. Ljubljana: Klinični center, Klinični oddelek za nefrologijo,
Publication year		2000
Volume		str. 39-42
Language		slo
Abstract		Background. The clinical significance of vesicoureteral reflux (VUR) in the transplanted kidney is still controversal yet it has been considered a predisposing factor for recurrent urinary infections. Beside surgical VUR can be treated endoscopically using collagen injected into the submucosal plane beneath the affected ureter. The aim was to assess the effectivness of this method in renal transplant recipients having VUR in graft kidney. Methods We evaluated 7 recipients (5 women, 2 men) aged 27 to 54 years with VUR grade III-IV ansley 1982) treated endoscopic by collagen injection. In all recipients the extravesical technique by Lutz of the ureter implantation was performed. The collagen Zyplast (Collagen Corporation, Palo Alto, USA) was injected using the needle aplicator (TIK Kobarid, Slovenia) submucosal on the upper and lower part of the transplanted ureter. The amount of collagen applied was 2-2,6 ml. Results. Ultrasound examination was performed 24 hours after collagen injection in purpose to localise collagen in bladder muscle and disclose urinary tract dilatation. Six weeks after the treatment x-ray cystogram was performed. In all recipient endoscopic correction of VUR was unsuccessful, VUR of the same grade persisted. Conclusion. We consider the failure of endoscopic treatment of VUR with collagen in kidney recipients is the technique of extravesical ureter implantation, graft ureter functioning as a rigid tube and quick collagen resorbtion by adjacent tissue.
Descriptors		KIDNEY TRANSPLANTATION VESICO-URETERAL REFLUX COLLAGEN ENDOSCOPY