Efficacy of Dextranomer/Hyaluronic Acid Copolymer (Deflux®) Injection for Vesicoureteral Reflux in Children

Hong, Suk-Jin; Hwng, Hyun-Hee; Hong, Eun-Hui; Cho, Min-Hyun; Chung, Sung-Kwang

doi:2009.13.2.229

J Korean Soc Pediatr Nephrol > Volume 13(2); 2009 > Article

J Korean Soc Pediatr Nephrol 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®) 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®) 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

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