Korean J Urol.  2007 Jun;48(6):620-626. 10.4111/kju.2007.48.6.620.

Dextranomer/Hyaluronic Acid Copolymer (Deflux(R)) Injection for Vesicoureteral Reflux in Children: the Efficacy and Safety

• Park YH
• Kim KM

• KMID: 1885544
• DOI: http://doi.org/10.4111/kju.2007.48.6.620

Abstract

PURPOSE: We evaluated the efficacy and safety of Deflux injection for treating vesicoureteral reflux (VUR) in children.
MATERIALS AND METHODS
Between January 2004 and May 2006, 49 children (28 boys and 21 girls) with a mean age of 51 months (5-182) underwent Deflux injection. VUR was unilateral in 19 cases (38.8%) and bilateral in 30 (61.2%), affecting 79 ureters. VUR was grades II to V in 26 cases (32.9%), 24 (30.4%), 16 (20.3%), and 4 (5.1%), respectively. Our clinical protocol involved ultrasonography at 6 weeks to evaluate the development of hydronephrosis and the creation of submucosal mound, and VCUG or RIVCU at 3 months to assess the VUR.
RESULTS
The median follow-up was 8.0 months (1-22). The cure rate at 3 months by the ureter was 81.6% (88.9% for grade I, 100% for grade II, 79.2% for grade III, 75.0% for grade IV, and 50.0% for grade V) and the cure rate was 84.8% for the total patients (100% for the unilateral cases and 80% for the bilateral cases). There were 16 patients with 1 year of follow-up and the cure rate was 88.5% by the ureter and 87.5% for the total patient. The severity of VUR (p=0.035) and the concomitant voiding dysfunction (p=0.001) were the significant predictors of a successful outcome. One patient complained of gross hematuria resolved within a few days.
CONCLUSIONS
Deflux injection was safe and efficacious with a low complication rate. The severity of VUR and the concomitant voiding dysfunction had significant adverse effects on the cure rate.

Keyword

Vesicoureteral reflux; Deflux; Minimally invasive surgical procedures

MeSH Terms

Child*
Clinical Protocols
Follow-Up Studies
Hematuria
Humans
Hydronephrosis
Surgical Procedures, Minimally Invasive
Ultrasonography
Ureter
Vesico-Ureteral Reflux*

Figure

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  Fig. 1 Questionnaire about dysfunctional voiding.

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  Fig. 2 Reflux status at 3 months and 1 year.

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