[Preliminary results of endoscopic treatment of vesicoureteric reflux in children. Prospective comparative study of Deflux vs. Coaptite].
BACKGROUND
The objective of this study is to compare the short-term and medium-term efficacy of Coaptite versus Deflux in the endoscopic treatment of vesicoureteric reflux in children.


METHODS
Over a period of 24 months, a cohort of 31 children with 44 refluxing vesicoureteric units were treated alternately by either Deflux implants (Group I, 24 refluxing units) or Coaptite implants (Group II, 20 refluxing units). This series comprised 40 solitary ureteric systems and 2 complete duplications. The two groups were comparable in terms of age at the time of the operation and distribution of severity of reflux. The quantity of product injected was identical in the 2 groups: 0.5 cc per ureter. All patients in group II received only one injection, while 2 Deflux injections were necessary in 2 patients and 3 injections were necessary in 1 patient in group I. All children were reviewed by ultrasound and retrograde cystography 3 months after the operation.


RESULTS
Reflux, regardless of grade, resolved in 70% of cases in the 2 groups (no significant difference). The cure rate was 75% for grade II and III in group I and 62.5% (grade II) and 70% (grade III) in group II, with no significant difference between the 2 groups. Two cases of grade IV reflux were cured after a single implantation of Coaptite in 1 case and Deflux in the other case. Complications, such as ureteric stasis or haemorrhage at the injection site, were not observed.


CONCLUSIONS
Although the efficacy of endoscopic treatment has now been clearly established, the choice of material to be injected is still controversial. This preliminary study did not reveal any significant difference in terms of cure rate, regardless of grade, between patients treated with Coaptite or Deflux. The medium-term and especially the long-term morbidity of these products still needs to be evaluated.
Merrot
Thierry
T
Service de Chirurgie Pédiatrique, Hôpital Nord, Marseille, France. tmerrot@ap-hm.fr
Ouedraogo
Isso
I
Hery
Géraldine
G
Alessandrini
Pierre
P
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D003911:Dextrans; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid; D008297:Male; D011446:Prospective Studies; D019736:Prostheses and Implants; D018666:Ureteroscopy; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
D003911:Dextrans; C094535:deflux; D006820:Hyaluronic Acid