Endoscopic treatment with Deflux for refluxing duplex systems

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Vesicoureteral reflux (VUR) in duplex systems presents a unique clinical challenge.
• Endoscopic management offers a less invasive alternative to surgical reimplantation.

Purpose of the Study:

• To evaluate the effectiveness and safety of the endoscopic Deflux procedure for treating VUR in duplex systems.
• To assess the institutional experience with this minimally invasive technique.

Main Methods:

• Retrospective review of patients treated with endoscopic Deflux for VUR in duplex systems (June 2003 - July 2007).
• Data collected included patient demographics, VUR grade, Deflux volume and number of injections, and outcomes including need for reimplantation surgery.
• Post-procedure assessment included radionuclide voiding cystourethrogram (VCUG) at 3 months.

Main Results:

• 16 patients (18 duplex ureteral systems) underwent the Deflux procedure for VUR grades II-V.
• The overall success rate was 94% after a maximum of three Deflux injections.
• Only one patient required surgical reimplantation due to persistent high-grade reflux.

Conclusions:

• The endoscopic Deflux procedure is a safe and effective minimally invasive treatment option for refluxing duplex systems.
• This technique provides a successful alternative to surgical intervention for VUR in complex ureteral anatomies.