title: Comparison of dextranomer/hyaluronic acid based bulking agents in the treatment of vesicoureteral reflux in children: Deflux versus Vurdex.
abstract: BACKGROUND
  The objective of this study was to compare the clinical efficacy of two similar tissue bulking agents, Deflux and Vurdex, used for a treatment of vesicoureteral reflux (VUR) in our institution.
  
  
  METHODS
  The case records of 104 children, treated endoscopically for primary VUR from January 2010 to January 2015, were retrospectively reviewed. Most of the patients were treated with Deflux until 2012, when use of Vurdex was started. Exclusion criteria were patients with secondary reflux due to neurogenic bladder, duplicated refluxing ureters, primarily operated patients and patients operated after first or second injection.
  
  
  RESULTS
  Endoscopic treatment of vesicoureteral reflux using Deflux was performed in 65 children (106 ureters). There were 24 patients with unilateral and 41 patients with bilateral VUR. After first injection of Deflux success was achieved in 74 ureters (69.8%), after second injection in 91 ureters (85.8%) and after third injection in 99 ureters (93.3%). The same procedure using Vurdex was performed in 39 children (58 ureters). There were 20 patients with unilateral and 19 patients with bilateral reflux. After first injection of Vurdex success was achieved in 43 ureters (74.1%), after second injection in 52 ureters (89.6%) and after third injection in 55 ureters (94.8%).
  
  
  CONCLUSIONS
  Overall success rate for patients treated with Deflux was 93.3% and for patients treated with Vurdex 94.8%. No significant difference in success rates between two groups was found (p = 0.714). However, Vurdex has an advantage because of the significantly lower price, but with same treatment results as Deflux.
authors.affiliation: Department of Pediatric Surgery, Split University Hospital, Split, Croatia.
authors.forename: Zenon
authors.initials: Z
authors.lastname: Pogorelić
authors.forename: Karla
authors.initials: K
authors.lastname: Gudelj
authors.forename: Dražen
authors.initials: D
authors.lastname: Budimir
authors.forename: Jakov
authors.initials: J
authors.lastname: Todorić
authors.forename: Miro
authors.initials: M
authors.lastname: Jukić
authors.forename: Dubravko
authors.initials: D
authors.lastname: Furlan
authors.forename: Đurđica
authors.initials: Đ
authors.lastname: Košuljandić
authors.forename: Marijan
authors.initials: M
authors.lastname: Saraga
mesh_terms: D000293:Adolescent; D001672:Biocompatible Materials / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003558:Cystoscopy; D003911:Dextrans / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000191:economics / Q000627:therapeutic use*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019736:Prostheses and Implants; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
chemical_list: D001672:Biocompatible Materials; D003911:Dextrans; C094535:deflux; C013471:dextranomer; D006820:Hyaluronic Acid