PEDIATRIC UROLOGY Long-term results after endoscopic VUR-treatment using dextranomer / hyaluronic acid copolymer – 5-year experience in a single-center

Abstract

BackgroundA 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.Patients and methodsBetween 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).ResultsNo 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.ConclusionSubureteral injection of Deflux® for children with VUR is an effective treatment option with a low complication rate.

Giant foreign body granuloma after endoscopic management of vesicoureteric reflux: a case report

“…Various agents like Teflon paste (Mentor, Santa Barbara, California), Macroplastique (Uroplasty Inc., Minneapolis, Minnesota), and cross-linked bovine collagen have been used earlier. Subsequently, Deflux ® (Q Med, Uppsala, Sweden) was approved by the United States Food and Drug Administration in 2001 [2]. There has been a steady increase in the usage of Deflux ® since then, not only in VUR but a trend towards the use of Deflux ® for other urological conditions have also emerged in the medical literature.…”

“…Author details 1 Department of Paediatric Surgery, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi 110029, India. 2 Department of Pathology, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi 110029, India.…”

Mucosal Injection as treatment for rectal prolapse in children with corrected anorectal malformation

“…Secondly, follow up time must be considered speci cally seeing as both absorbable and non-absorbable agents were injected and, while not showing any short-term differences, might show variable long-term outcomes. Longer-term effects of up to 18 years' follow up are known for both agents when used for VUR treatments, with both showing favourable outcomes (albeit a slightly higher recurrence rate for Dx/HA) and hardly any observed long-term complications [18][19][20].…”