ENDOSCOPIC TREATMENT OF VESICOURETERAL REFLUX WITH COLLAGEN - PRELIMINARY-REPORT AND COST-ANALYSIS

Purpose: We determined therapeutic and operative cost efficacy of endo scopic collagen injection for vesicoureteral reflux. Materials and Met hods: We performed a multicenter study of 10 male and 23 female sequen tial patients (45 renal units) with vesicoureteral reflux and a surgic al indication. Patients were skin tested with collagen and when negati ve, they underwent endoscopic injection. Renal ultrasound/cystography was done 3 months after treatment. Cost analysis was performed at 1 in stitution. Results: Reflux was grade I in 2 renal units, II in 18, III in 15 and IV in 10. The majority of cases were single systems with pr imary reflux. We performed 1 treatment in 32 renal units, 2 in 6, 3 in 6 and 4 in 1. Cure was evident in 31 of 38 renal units (81.6%) and 21 of 27 patients (78%) 3 months after the last injection. Patient morbi dity was minimal. Operative cost per renal unit was $1,599.68 for coll agen injection and $9,144.47 for reimplantation. Conclusions: Endoscop ic injection of collagen is effective treatment for vesicoureteral ref lux. Furthermore, it causes minimal morbidity and may effect cost savi ngs in health care management.