Yong Hyun Park; Kwang Myung Kim

doi:10.4111/kju.2007.48.6.620

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

Original Article

Korean Journal of Urology

Korean Journal of Urology 2007; 48(6): 620-626.

Published online: 30 June 2007

DOI: https://doi.org/10.4111/kju.2007.48.6.620

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

Yong Hyun Park, Kwang Myung Kim

Department of Urology, Seoul National University College of Medicine, Seoul, Korea.

Corresponding author (kwang@plaza.snu.ac.kr)

Received 22 January 2007 Accepted 26 April 2007

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.

Keywords: Vesicoureteral reflux, Deflux, Minimally invasive surgical procedures

Figures and Tables

Fig. 1

Questionnaire about dysfunctional voiding.

Fig. 2

Reflux status at 3 months and 1 year.

Table 1

Patients' characteristics

UTI: urinary tract infection

Table 2

Preoperative parameters

Table 3

Indications for surgery

^*some children had more than one indications of surgery. UTI: urinary tract infection, VUR: vesicoureteral reflux

Table 4

Postoperative reflux at 3 months

Table 5

Factors predicting the surgical results by the chi-square test

VUR: vesicoureteral reflux

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