Deflux as a Minimally Invasive Solution for Vesicoureteral Reflux Following Ureteral Reimplantation

A middle-aged female with a history of iatrogenic right ureteral injury and surgical reimplantation was referred to our clinic for recurrent urinary tract infection (UTI) with right-sided pyelonephritis and fever. The workup revealed Grade 4 vesicoureteral reflux (VUR) on cystogram and moderate hydroureteronephrosis with cortical scarring on computed tomography. She was offered surgical repair versus attempted minimally invasive endoscopic treatment. The patient elected for endoscopic treatment with a hyaluronic acid copolymer (Deflux), a bulking agent typically used to treat VUR in children. Posttreatment results showed a significant reduction in VUR severity, reduction of her recurrent UTIs, and resolution of chronic flank pain. This case report demonstrates a successful utilization of this approach for symptomatic reflux following ureteral reimplantation in an adult.