title: Long-term results after endoscopic VUR-treatment using dextranomer / hyaluronic acid copolymer - 5-year experience in a single-center.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  Subureteral injection of Deflux(®) for children with VUR is an effective treatment option with a low complication rate.
authors.affiliation: Department of Urology, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Joerg
authors.initials: J
authors.lastname: Seibold
authors.affiliation: Department of Urology, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Maren
authors.initials: M
authors.lastname: Werther
authors.affiliation: Department of Urology, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Saladin H
authors.initials: SH
authors.lastname: Alloussi
authors.affiliation: Department of Urology, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Aufderklamm
authors.affiliation: Department of Urology, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Georgios
authors.initials: G
authors.lastname: Gakis
authors.affiliation: Department of Urology, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Tilman
authors.initials: T
authors.lastname: Todenhöfer
authors.affiliation: Department of Urology, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
authors.affiliation: Department of Urology, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schwentner
keywords: dextranomer/hyaluronic acid; health-related quality of life; minimally invasive therapy; subureteral injection; vesicoureteral reflux