以注射填充劑（Vantris®）進行兒童膀胱輸尿管逆流之內視鏡治療：病例報告

鄭宛妤¹、蘇家震¹、黃冠華¹

¹台南永康奇美醫院,外科部,泌尿科

Endoscopic Management of Pediatric Vesicoureteral Reflux with Injection Bulging Agent (Vantris®): A Case Report 

Wan-Yu Cheng ¹、Chia-Cheng Su¹、Steven K. Huang¹

¹ Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan;

Introduction: We present a case of pediatric bilateral high-grade vesicoureteral reflux (VUR) successfully treated with endoscopic Vantris® injection.

Case Presentation: A 13-month-old boy presented with recurrent febrile urinary tract infections since two months of age. DMSA renal scan demonstrated left upper pole scarring, with differential renal functions of 48% on the left and 52% on the right. Voiding cystourethrography (VCUG) revealed bilateral VUR—grade IV on the left and grade III on the right. Under intravenous general anesthesia, bilateral Vantris® injections (0.4 mL each at the 6 o’clock position) were performed by cystoscopy without complications. Postoperative ultrasonography showed only mild right pelvic dilatation. Follow-up VCUG and DMSA scans were scheduled two months postoperatively to assess reflux resolution and renal function.

Discussion: Endoscopic injection with Vantris® provides a minimally invasive and durable treatment option for pediatric VUR. Owing to its non-biodegradable nature, Vantris® offers long-lasting subureteric coaptation and a high success rate, even in high-grade or complex cases. Compared with biodegradable bulking agents, Vantris® demonstrates more sustained reflux resolution and low morbidity. This case highlights its efficacy and safety as a viable alternative to open ureteral reimplantation in children with high-grade VUR.

Conclusion: Endoscopic Vantris® injection represents an effective, durable, and minimally invasive therapeutic option for the management of pediatric high-grade vesicoureteral reflux.