Korean J Urol.  2010 Feb;51(2):128-131.

Endoscopic Subureteral Injection for the Treatment of Vesicoureteral Reflux in Children: Polydimethylsiloxane (Macroplastique(R)) versus Dextranomer/Hyaluronic Acid Copolymer (Deflux(R))

• Bae YD
• Park MG
• Oh MM
• Moon DG

Abstract

PURPOSE: The aim of this study was to compare cure rates and complications of polydimethylsiloxane (Macroplastique(R)) and dextranomer/hyaluronic acid copolymer (Deflux(R)) in the treatment of vesicoureteral reflux (VUR).
MATERIALS AND METHODS
From April 2001 to March 2008, 29 boys and 42 girls (total of 115 ureters) with a mean age of 6 years who had undergone endoscopic subureteral transurethral injection for VUR were enrolled. A single subureteral injection of Macroplastique was performed in 31 ureters in 23 children (group I; grade II: 4; grade III: 12; grade IV: 9; grade V: 6), and a single subureteral injection of Deflux was performed in 84 ureters in 48 children (group II; grade II: 24; grade III: 14; grade IV: 25; grade V: 21). Renal ultrasound was done 1 day after injection, and voiding cystourethrography (VCUG) was done at 3 months. Successful reflux correction was defined as absent or grade I reflux on follow-up VCUG.
RESULTS
No significant difference in success rates was observed between group I and group II [80.6% (25/31) vs. 78.6% (66/84), respectively, p>0.05]. The following postoperative complications developed: ureteral obstruction in 2 ureters of group I and 3 ureters of group II, asymptomatic urinary tract infection in 3 patients of group I and 2 patients of group II, and bladder calcification by erosion or mucosal necrosis in 2 patients of group I.
CONCLUSIONS
Despite differences in material properties, both Macroplastique and Deflux were safe for the treatment of children with VUR. Because of the risk of bladder mucosal necrosis and substantial decreases in volume after implantation, long-term follow-up is required.

Keyword

Vesicoureteral reflux; Deflux

MeSH Terms

Child
Dextrans
Dimethylpolysiloxanes
Follow-Up Studies
Humans
Hyaluronic Acid
Necrosis
Postoperative Complications
Ureter
Ureteral Obstruction
Urinary Bladder
Urinary Tract Infections
Vesico-Ureteral Reflux
Dextrans
Dimethylpolysiloxanes
Hyaluronic Acid

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