Does deflux alter the paradigm for the management of children with vesicoureteral reflux?
The recent approval by the US Food and Drug Administration of Deflux (Q Med, Uppsala, Sweden), a particulate biodegradable polymer of dextran, has led to an understandable enthusiasm for treating children with vesicoureteral reflux by a routinely simple outpatient endoscopic procedure. However, Deflux is but one of a variety of particulate substances, both permanent and absorbable, that have been used to treat reflux in Europe for well over a decade with varying degrees of success. The purpose of this review is to place Deflux in this wider context to anticipate what can be expected realistically regarding the efficacy and potential hazards of this seductive technique and to make recommendations regarding its incorporation, in selected cases, in our therapeutic armamentarium.
Aaronson
Ian A
IA
Medical University of South Carolina, Clinical Science Building, 96 Jonathan Lucas Street, Room 644, P.O. Box 250620, Charleston, SC 29425, USA. aaronson@musc.edu
D002675:Child, Preschool; D003911:Dextrans / Q000627:therapeutic use*; D004724:Endoscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D007223:Infant; D015552:Injections, Intralesional; D008297:Male; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018666:Ureteroscopy / Q000379:methods; D014563:Urodynamics; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000188:drug therapy*
D003911:Dextrans; C094535:deflux; D006820:Hyaluronic Acid
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