Endoscopic correction of vesicoureteral reflux in children using autologous chondrocytes: Preliminary results

Purpose: Previous approaches to the endoscopic correction of vesicoureteral reflux have used foreign bulking substances, raising concern regarding saf ety and long-term efficacy. We describe the results of a clinical trial usi ng transurethral injection of autologous chondrocytes to correct vesicouret eral reflux in children. Materials and Methods: A total of 29 children (46 ureters) with grades II t o IV vesicoureteral reflux were treated at 2 sites. Each child underwent cy stoscopy and ear cartilage biopsy at the initial setting. Chondrocytes were grown in culture for 6 weeks. Patients then returned for transurethral inj ection of chondrocytes into the bladder trigone to correct reflux. Ultrasou nd was performed 1 month and radionuclide cystography was done 3 months pos toperatively to confirm reflux resolution. When reflux persisted, repeat tr eatment with stored chondrocytes was offered. Results: Initial chondrocyte injection corrected reflux in 26 of the 46 ure ters (57%), while secondary injection was successful in 12 of 19 (63%). Ove rall reflux was corrected in 38 of the 46 ureters (83%) and in 24 of the 29 patients (83%). There were no significant complications. Conclusions: Transurethral injection of autologous chondrocytes to correct vesicoureteral reflux in children appears to be an effective and safe techn ique that holds promise for treating this congenital abnormality in a minim ally invasive fashion.