long-term follow-up of autologous blood cell transplantation along with platelet rich plasma in treatment of women with vesicoureteral reflux: A clinical trial study

Introduction: Vesicoureteral reflux is a common urological issue. The interventions for low-grade reflux have been evolved from ureteral reimplantation to endoscopic injection of a bulking agent. This study aimed to evaluate the therapeutic efficacy of endoscopic subureteric injection of autologous peripheral blood cells along with platelet-rich plasma. Methods: This clinical trial study was performed in the Urology department of Imam Reza Hospital in Mashhad, 2015. A total of 17 vesicoureteral reflux patients, 15–35 years old, who fulfilled our inclusion criteria, were evaluated. The endoscopic injection was administered by one surgeon in all patients at 6 o’clock position and 0.5 cm beneath the ureteral orifice, followed by renal ultrasonography and voiding cystourethrogram (VCUG), 3 and 18 months after the injection. The success of the injection was determined according to the disappearance of the symptoms and remission of the vesicoureteral reflux in following VCUGs. If the reflux persisted, the injection was re-administered after three months. Results: The success rates of each unit after the first and second injections were 89% and 94%, respectively. All the patients were evaluated by ultrasonography and VCUG for any reflux recurrence. Complications such as late recurrence and obstruction during 18 months follow-up were not determined. Conclusion: This study suggests that endoscopic injection of total blood nucleated cells and platelets is effective for the treatment of vesicoureteral reflux and recurrent pyelonephritis. This endoscopic injection is simple, non-invasive, non-antigenic, and with an acceptable success rate.