Long-term Results of Endoscopic Deflux(R) Injection for Vesicoureteral Reflux in Children.
10.3339/chikd.2015.19.1.31
- Author:
Hwanik KIM
1
;
Byung Soo KIM
;
Hae Il CHEONG
;
Byoung Soo CHO
;
Kwang Myeong KIM
Author Information
1. Department of Urology, Seoul National University College of Medicine, Seoul, Korea. kwang@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Vesicoureteral reflux;
Deflux(R);
Endoscopic treatment;
Children;
Urinary tract infection
- MeSH:
Child*;
Clinical Protocols;
Humans;
Multivariate Analysis;
Recurrence;
Ureter;
Urinary Tract Infections;
Vesico-Ureteral Reflux*
- From:Childhood Kidney Diseases
2015;19(1):31-38
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We evaluated the long-term results of endoscopic Deflux(R) injection for treating vesicoureteral reflux (VUR) in children. METHODS: Between September 2004 and September 2014, 243 children (137 boys and 106 girls) with a mean age of 53 months underwent Deflux(R) injection. Our clinical protocol included radionuclide voiding cystography (RNC) at postoperative 3 months, 1 year and 3 years to assess the VUR resolution. RESULTS: The cure rates at 3 months, 1 year, and 3 years by patients were 70.8%, 64.3%, and 65.6% for the total patients and 79.2%, 75.2%, and 76.4%, for the ureters, respectively. The recurrence rate of postoperative febrile urinary tract infection (UTI) was 20% in patients without VUR at postoperative 1 year. Twenty patients undergoing ureteroneocystostomy (UNC) significantly had younger age (P=0.003), higher VUR grade (P<0.001), and lower success rates of Deflux(R) injection (P<0.05). On univariate analysis, older age (P=0.014) and lower grade of VUR (P=0.031) were the significant predictors of a successful outcome. But there was none on multivariate analysis. Younger age, especially age of 0-12 month-old, was the only significant predictor of postoperative febrile UTI recurrence on both univariate and multivariate analysis. CONCLUSION: Deflux(R) injection is efficacious with a low complication rate for the anti-reflux procedure in children. There is low recurrence rate of UTI though VUR persists, and high probability of no VUR at 3 years if no VUR at 1 year. It is recommendable not to perform follow-up RNC at 3 years routinely if no VUR at 1 year.
