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Journal of the Korean Society of Pediatric Nephrology 2009;13(2): 229-234. doi: https://doi.org/10.3339/jkspn.2009.13.2.229
방광요관역류 환아에서 내시경적 요관 점막하 Dextranomer/hyaluronic acid copolymer ($Deflux^{(R)}$) 주사요법의 효과에 대한 연구
홍석진, 황현희, 홍은희, 조민현, 정성광
1경북대학교 의학전문대학원 소아과학교실
2창원파티마병원 소아청소년과
3경북대학교 의학전문대학원 소아과학교실
4경북대학교 의학전문대학원 소아과학교실
5경북대학교 의학전문대학원 비뇨기과학교실
Efficacy of Dextranomer/Hyaluronic Acid Copolymer ($Deflux^{(R)}$) Injection for Vesicoureteral Reflux in Children
Suk-Jin Hong, Hyun-Hee Hwng, Eun-Hui Hong, Min-Hyun Cho, Sung-Kwang Chung
1Department of Pediatrics, Kyungpook National University School of Medicine
2Department of Pediatrics, Fatima Hospital
3Department of Pediatrics, Kyungpook National University School of Medicine
4Department of Pediatrics, Kyungpook National University School of Medicine
5Department of Urology, Kyungpook National University School of Medicine
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ABSTRACT
Purpose : The aim of this study was evaluating the efficacy of endoscopic $Deflux^{(R)}$ submucosal injection in children with primary vesicoureteral reflux (VUR).
Methods : Retrospective analysis of medical record was conducted on 38 children (59 ureters) who underwent endoscopic $Deflux^{(R)}$ injection due to primary VUR. Data were collected from March 2000 to February 2006. Mean infused amount of $Deflux^{(R)}$ was 0.77 cc. After $Deflux^{(R)}$ injection, patients were reassessed by voiding cystourethrogram (VCUG) 6 months later.
Results : The success rate of endoscopic $Deflux^{(R)}$ submucosal injection 6 months later by VCUG was 100% for grade 1 VUR, 87.5% for grade 2, 60% for grade 3, 26.6% for grade 4, 16.6% for grade 5, respectively and there was negatively significant correlation between success rate and grade of VUR (P<.01). Degree of improvement of VUR by endoscopic $Deflux^{(R)}$ submucosal injection was not related to age at diagnosis, time to operation, existence of voiding dysfunction or constipation and infused amount of $Deflux^{(R)}$. However, group with anticholinergics medication had significantly lower success rate than non-medication group (P<0.047).
Conclusion : Endoscopic $Deflux^{(R)}$ submucosal injection is effective therapy in patient with primary VUR, especially low grade VUR. It can be not only a useful substitute for prophylaxis with antibiotics, but also an effective management prior to ureteroneocystostomy in children with primary VUR.
Key words: Vesicoureteral Reflux | $Deflux^{(R)}$ | Child
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