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[Long-term results after endoscopic subureteral injection for VUR using dextranomer/hyaluronic acid copolymer : a

J Seibold1, M Werther, K-D Sievert

  • 1Klinik für Urologie, Eberhard-Karls-Universität, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Deutschland. joerg.seibold@med.uni-tuebingen.de

Der Urologe. Ausg. A
|January 12, 2010
PubMed

Insights

Endoscopic subureteral injection of dextranomer/hyaluronic acid copolymer (Deflux) is an effective treatment for pediatric vesicoureteral reflux (VUR). Long-term follow-up shows a low complication rate and improved quality of life for children with VUR.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Biomaterials in Medicine

Background:

  • Vesicoureteral reflux (VUR) in children is commonly treated with bulking agents.
  • Dextranomer/hyaluronic acid copolymer (Deflux) is an option for endoscopic VUR correction.

Purpose of the Study:

  • To evaluate the long-term efficacy and safety of Deflux for treating pediatric VUR.
  • To assess the impact of Deflux treatment on urinary tract infections (UTIs) and quality of life.

Main Methods:

  • A cohort of 21 children (30 ureters) with VUR grades I-IV underwent outpatient endoscopic subureteral injection of Deflux.
  • Postoperative voiding cystourethrogram (VCUG) at 6 weeks assessed VUR resolution.
  • Long-term follow-up included monitoring for UTIs and parent questionnaires on quality of life.

Main Results:

  • No intra- or postoperative complications were observed.
  • 83% of ureters showed no VUR on VCUG at 6 weeks post-injection.
  • After a median follow-up of 2.5 years, 90% of treated ureters in 17 children were free of VUR and UTIs, with excellent quality of life reported.

Conclusions:

  • Subureteral injection of Deflux is a safe and effective treatment for pediatric VUR.
  • The procedure offers a low complication rate and positive long-term outcomes, including reduced UTIs and improved quality of life.
Abstract

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