{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:48:26Z","timestamp":1785826106208,"version":"3.56.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Endoscopic subureteral injection (ESI) of bulking agents is an established treatment for vesicoureteral reflux (VUR) in pediatric populations; however, evidence in adults with neurogenic bladder remains limited. To systematically review the available evidence regarding the efficacy and safety of ESI for the treatment of VUR in adults with neurogenic bladder.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature search was conducted in PubMed, Web of Science, and Cochrane Library up to December 2025, following PRISMA guidelines. Studies including adult patients with neurogenic bladder undergoing ESI for VUR were included. Data on patient characteristics, urodynamic findings, perioperative outcomes, and complications were extracted. Due to heterogeneity and limited sample size, a meta\u2010analysis was not performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six studies comprising 69 patients met the inclusion criteria. The mean age was 47.8 years, and spinal cord injury was the most common etiology. The pooled baseline VUR grade was 2.5. Cure rates after a single ESI ranged from 50% to 88.9%, with improvement rates reaching up to 94.4% when partial responses were included. Most patients requiring a second injection achieved complete resolution. Macroplastique was the most frequently used bulking agent. No major complications were reported, although reporting was limited. Follow\u2010up ranged from 12 to 28 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ESI with bulking agents appears to be a safe and potentially effective minimally invasive option for treating VUR in adults with neurogenic bladder. However, current evidence is limited by small sample sizes, heterogeneity, and lack of high\u2010quality comparative studies. Further prospective studies are needed to define optimal patient selection and treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/nau.70396","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:16:43Z","timestamp":1785824203000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic Subureteral Injection for Vesicoureteral Reflux in Adults With Neurogenic Bladder: Implications for Patients With Spinal Cord Injury \u2013 A Systematic Review"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7383-5322","authenticated-orcid":false,"given":"Leandro","family":"Blas","sequence":"first","affiliation":[{"name":"Department of Urology Fundacio Institut Guttmann Badalona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ervin","family":"Amaya","sequence":"additional","affiliation":[{"name":"Department of Urology Fundacio Institut Guttmann Badalona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irma","family":"Ospina","sequence":"additional","affiliation":[{"name":"Department of Urology Fundacio Institut Guttmann Badalona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Borau","sequence":"additional","affiliation":[{"name":"Department of Urology Fundacio Institut Guttmann Badalona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.289.6436.7"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/309626"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1038\/sc.1996.118","article-title":"Endoscopic Treatment of Vesicoureteric Reflux in Adults With a Neuropathic Bladder","volume":"34","author":"Foley S. J.","year":"1996","journal-title":"Spinal Cord"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acuro.2013.02.007"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.1930050206"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.2010.02545.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101091"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.04866.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2010.12.080"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02388714"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.1997.tb00305.x"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101090"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2018.1433266"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02564736"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0210-4806(07)73651-3"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000357440"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2008.08148.x"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1159\/000127341"},{"issue":"1","key":"e_1_2_12_21_1","first-page":"58","article-title":"Analyse Des \u00c9checs Du Traitement Endoscopique Du Reflux V\u00e9sico\u2010R\u00e9nal Chez L'enfant Par Injections De T\u00e9flon Ou De Collag\u00e8ne Et R\u00e9sultats Pr\u00e9liminaires Des Injections De Macroplastique [Analysis of the Failure of Endoscopic Treatment of Vesico\u2010Renal Reflux in Children Using Injections of Teflon and Collagen and the Preliminary Results of Injections of Macroplastic]","volume":"5","author":"Dodat H.","year":"1995","journal-title":"Progr\u00e8s en urologie: journal de l'Association fran\u00e7aise d'urologie et de la Soci\u00e9t\u00e9 fran\u00e7aise d'urologie"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(05)64349-2"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348948309200512"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-5347(17)41483-2"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70396","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.70396","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.70396","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:16:44Z","timestamp":1785824204000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.70396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,3]]},"references-count":23,"alternative-id":["10.1002\/nau.70396"],"URL":"https:\/\/doi.org\/10.1002\/nau.70396","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,3]]},"assertion":[{"value":"2026-04-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"nau.70396"}}