To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: AAP: Dextranomer Effective Bulking Agent for Treatment of Pediatric Urinary Incontinence URL: http://www.pslgroup.com/dg/20B8E2.htm Doctor's Guide October 23, 2001
By Alison Palkhivala Special to DG News SAN FRANCISCO, CA -- October 23, 2001 -- Dextranomer is effective as a nonimmunogenic bulking agent for the endoscopic treatment of urinary incontinence in the pediatric population, according to new research. Treatment of urinary incontinence through endoscopic procedures using bulking agents has attained popularity in recent years. Dextranomer is a new synthetic co-polymer that has been used successfully for the treatment of vesico-ureteral reflux. The results of two studies on the use of a suspension of dextranomer particles in a 1% hyaluronan solution called Deflux as a bulking agent for the treatment of urinary incontinence were presented here this week at the National Conference and Exhibition of the American Academy of Pediatrics (AAP). One presentation was made by Paolo Caione, MD, who is from the department of pediatric urology at Bambino Gesu Children's Hospital in Rome, Italy. He and colleagues analyzed results of 16 patients (aged eight to 22 years) treated endoscopically for urinary incontinence using Deflux over a two-year period. Three of the subjects had neurogenic incontinence, while the other 13 had structural deficiency of the bladder outflow. An average of 2.5 cc of Deflux was endoscopically delivered to patients via a 4 F cannula at the bladder neck in 12 patients and along the posterior urethra in the other four (all males). Six patients required a second treatment, and three required a third. At six-month follow-up, both mean dry interval after bladder emptying and mean voided volume or functional bladder capacity had increased significantly compared to their preoperative states. Three patients became fully daytime dry, and nine improved. Two were fully nighttime dry, and six improved their nighttime dryness. Thirteen patients completed one year of follow-up. At this point, a slight decrease in daytime dry interval was detected, but this difference did not reach statistical significance. The second study was presented by Dr. Henri B. Lottmann, MD, from the pediatric urology department of the Fondation Hôpital St-Joseph in Paris, France. His team treated 33 consecutive children (aged 5 to 18 years) suffering from severe incontinence requiring diapers due to a sphincteric incompetence with one or two endoscopic injections of Deflux. At one-month follow-up of 31 patients, 14 were dry and were significantly nine improved. At one-year follow-up of 28 patients, six were dry and six were improved. At two years, five of 24 patients followed-up were dry and four were improved. Three of the five dry patients developed an overactive poorly compliant bladder and required a subsequent augmentation. In another 12 patients, the bladder capacity has increased significantly. "The overall success rate at three years is 50 percent, and results are pretty stable after one year," said Dr. Lottmann. "… Endoscopic treatment of sphincteric incontinence with Deflux was successful for 50 percent of our patients over a three-year period. Recurrence of incontinence after six months or more may be a sign of bladder decompensation." --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.