Comparative Analysis of Ureteral Reimplantation and Dextranomer/Hyaluronic Acid Injection Between Two Centers With Systematic Review and Meta-Analysis.
Jin Kyu Kim, Beverly Miranda, Mandy Rickard et al.
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In 30 seconds
This study compared dextranomer/hyaluronic acid (Dx/HA) injection and ureteral reimplantation in children under 18 with recurrent UTIs. Conducted as a multicenter cohort study and meta-analysis, it found that while Dx/HA had shorter operative times (21 vs 140 minutes; P < .001) and lengths of stay (0 vs 1 day; P < .001), it was associated with higher rates of postoperative UTIs (19.6% vs 3.8%; P < .001).
Key findings
- Dx/HA had a significantly shorter operative time of 21 minutes compared to 140 minutes for reimplantation (P < .001).
- Postoperative UTI rates were higher after Dx/HA at 19.6% compared to 3.8% for reimplantation (P < .001).
- Reimplantation was favored for radiographic resolution with a risk ratio for nonresolution of 4.30 (P = .0003).
- Reoperation rates were also lower for reimplantation with a risk ratio of 6.42 (P < .00001).
Why it matters
Understanding the comparative effectiveness of surgical options for pediatric vesicoureteral reflux is crucial for optimizing patient outcomes. This study highlights the trade-offs between perioperative advantages and the risk of postoperative complications.
What to keep in mind
Evidence certainty was limited by heterogeneity and predominantly nonrandomized data.