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Updated: May 2, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Long-term results after endoscopic VUR-treatment using dextranomer / hyaluronic acid copolymer - 5-year experience in
Joerg Seibold1, Maren Werther1, Saladin H Alloussi1
1Department of Urology, Eberhard-Karls-University, Tübingen, Germany.
Insights
Endoscopic treatment using dextranomer/hyaluronic acid copolymer (Deflux®) effectively corrects vesicoureteral reflux (VUR) in children, showing high success rates and improving quality of life with minimal complications.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Biomaterials in Medicine
Background:
- Vesicoureteral reflux (VUR) in children often requires intervention.
- Various bulking agents exist for endoscopic VUR correction.
- Dextranomer/hyaluronic acid copolymer (Deflux®) is one such agent.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of endoscopic subureteral injection of Deflux® for VUR treatment in pediatric patients.
- To assess the impact of Deflux® treatment on urinary tract infection (UTI) rates and quality of life (QoL).
Main Methods:
- A cohort of 21 children (30 ureters) with VUR underwent outpatient endoscopic subureteral injection of Deflux®.
- Voiding cystourethrogram (VCUG) was performed 6 weeks postoperatively.
- Long-term follow-up included assessment of VUR recurrence, UTI, and parental QoL questionnaires.
Main Results:
- A high success rate was observed, with 83% of ureters showing no VUR 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.
- No significant intra- or postoperative complications were reported.
Conclusions:
- Subureteral injection of Deflux® is a safe and effective treatment for pediatric VUR.
- The procedure demonstrates a low complication rate and positive long-term outcomes.
- Successful treatment significantly improves QoL for affected children and their families.
Background:
A number of bulking agents have been used for the endoscopic correction of vesicoureteral reflux in children. We present our long-term results of endoscopic use of dextranomer/hyaluronic acid copolymer (Deflux(®)) for VUR treatment in children.
Patients And Methods:
Between 2004 and 2008, 21 children underwent endoscopic subureteral injection of Deflux(®) in 30 ureters as an outpatient procedure. Twelve children had unilateral reflux (2 duplicated systems) and nine had bilateral reflux. Median age was 5-years (6-months to 14.9-years). Six weeks postoperatively, a voiding cystourethrogram was performed. This study examined the disappearance of VUR and urinary tract infection (UTI) in the long-term follow-up as well as QoL (questionnaire of the parents).
Results:
No intra- or postoperative complications had been noticed. In 25 ureters (83%), VCUG showed no VUR 6-weeks postoperatively. Three children received a 2nd injection (two successful). After a median follow-up of 2.5 years, 27 ureters in 17 children (90%) had no urinary tract infection and VUR. The questionnaire results in regard to quality of life (QoL) were very good in the successfully treated children and the parents would choose the same treatment option again.
Conclusion:
Subureteral injection of Deflux(®) for children with VUR is an effective treatment option with a low complication rate.
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