engleski

Endoscopic treatment of vesicoureteral reflux with Deflux-a single Croatian center experience

Introduction: Vesicoureteral reflux (VUR) is a common condition that may lead to renal damage and end-staged renal failure. Traditionally, treatment options are long term prophylactic antibiotics or ureterocystoneostomy. Recently, promising results of endoscopic treatment by a subureteral injection of dextranomer/hyaluronic acid copolymer (Deflux) were demonstrated.Material and methods: Medical records of 41 patients ( 7 boys and 34 girls) who received Deflux injections for treatment of VUR from 2004 to 2011 were reviewed for oucome. All the patients were followed up with voiding cystourethrography at 6 months after the procedure.Results: The mean age at the tretment was 6 years and 6 months (range, 3 years and 6 months to 9 years and 8 months). A total of 32 patients (78.1 %) had unilateral VUR and 9 patients (21.9 %) had bilateral VUR, comprising 50 treated renal units. Overall cure rate was 78.0 % (39/50). Among the 50 renal units treated, 60.0 % (30/50) were cured with a single injection, and a second and third injection raised the cure rate to 76.0 % (38/50) and 78.0 % (39/50), respectively. Resolution of VUR, defined as grade, was seen in 1/1 (100.0 %), 17/20 (85.0 %), 20/27 (74.0 %) and 1/2 (50.0 %) ureters from grade I do IV respectively. No procedure-related complications were seen.Conclusions: Endoscopic treatment with Deflux is an effective and safe treatment for VUR. In our study, it demonstrated a cure rate of 78.0 % of renal units. With this promising success rate, we could recommend the use of endoscopic Delux injection as the first line treatment for children with VUR. Further experience and increased use of Deflux may improve our cure rate.

endoscopic treatment; vesicoureteral reflux; Croatian center

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