Delayed Obstruction With Asymptomatic Loss of Renal Function After Dextranomer/Hyaluronic Acid Copolymer (Deflux) Injection for Vesicoureteral Reflux: A Close Look at a Disturbing Outcome.
Dextranomer/hyaluronic acid copolymer (Deflux) first received Food and Drug Administration approval in 2001 for endoscopic injection in children with grade II-IV vesicoureteral reflux VUR. As experience has grown, Deflux has been used more liberally with encouraging results. We report 3 cases where Deflux was used in off-label fashion, resulting in delayed ureteral obstruction and loss of renal function (range 18-52 months postoperatively). We now place increased emphasis on the need for long-term follow-up after Deflux in both routine and complex cases, particularly in situations of off-label use.
Lurie Children's Hospital, Chicago, IL. Electronic address: dimitri_papagiannopoulos@rush.edu.
Dimitri
D
Papagiannopoulos
Lurie Children's Hospital, Chicago, IL.
Ilina
I
Rosoklija
Lurie Children's Hospital, Chicago, IL.
Earl
E
Cheng
Lurie Children's Hospital, Chicago, IL.
Elizabeth
E
Yerkes
D058070:Asymptomatic Diseases; D002648:Child; D002675:Child, Preschool; D003911:Dextrans / Q000008:administration & dosage / Q000009:adverse effects*; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D007223:Infant; D015552:Injections, Intralesional / Q000009:adverse effects; D007677:Kidney Function Tests; D008297:Male; D019736:Prostheses and Implants; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014567:Urography; D013520:Urologic Surgical Procedures / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000628:therapy*
D003911:Dextrans; C094535:deflux; D006820:Hyaluronic Acid