[Long-term results after endoscopic subureteral injection for VUR using dextranomer/hyaluronic acid copolymer : a five years experience].
BACKGROUND
A number of bulking agents have been used for the endoscopic correction of vesicoureteral reflux in children. We present the long-term results of endoscopic use of dextranomer/hyaluronic acid copolymer (Deflux) for VUR grade I-IV in children.


METHODS
Between 2004 and 2008, 21 children underwent endoscopic subureteral injection of Deflux in 30 ureters as an outpatient procedure. Twelve children had a unilateral reflux (two duplicated systems) and nine had a bilateral reflux. The median age was 5 years (6 months to 14.9 years). Six weeks postoperatively a voiding cystourethrogram (VCUG) was performed. This study examined the disappearance of VUR and urinary tract infection (UTI) as well as the quality of life (parents' questionnaire) during long-term follow-up.


RESULTS
No intra- and postoperative complications were noticed. In 25 ureters (83%) VCUG showed no VUR 6 weeks postoperatively. In three children a second injection was done (two were successful). After a median follow-up of 2.5 years 27 ureters in 17 children (90%) had no UTI and VUR. The results of the questionnaire regarding quality of life were very good in the successfully treated children and the parents would choose the same treatment option again.


CONCLUSIONS
Subureteral injection of Deflux for children with VUR is an effective treatment option for VUR with a low complication rate.
Seibold
J
J
Klinik für Urologie, Eberhard-Karls-Universität, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Deutschland. joerg.seibold@med.uni-tuebingen.de
Werther
M
M
Sievert
K-D
KD
Stenzl
A
A
D001672:Biocompatible Materials / Q000008:administration & dosage*; D003911:Dextrans / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D007267:Injections; D011183:Postoperative Complications / Q000523:psychology; D019736:Prostheses and Implants; D011788:Quality of Life / Q000523:psychology; D018666:Ureteroscopy; D014563:Urodynamics / Q000502:physiology; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000145:classification / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*
D001672:Biocompatible Materials; D003911:Dextrans; C094535:deflux; D006820:Hyaluronic Acid