OBJECTIVE: Endoscopic correction of vesicoureteral reflux has evolved as a viable alternative to open surgery. This study was conducted to review the experience of a single institution with the endoscopic Deflux procedure and assess its effectiveness in the treatment of vesicoureteral reflux.

MATERIALS AND METHODS: A retrospective review of patients who underwent endoscopic Deflux treatment for primary vesicoureteral reflux (VUR) between January 2005 and December 2010 was performed. Data collected included: age, gender, unilateral or bilateral treatment, pre-operative grade of VUR on voiding cystourethrogram (VCUG), and the number of Deflux injections per patient.

RESULTS: Sixteen patients [7 (43.75%) males and 9 (56.25%) females] were included in this study. The ages ranged from 6 months to 8 years old with a mean age of 3.15 years. Four (25%) patients had bilateral VUR while 12 (75%) had unilateral VUR, with a total of 21 refluxing ureters. Three had Grade II reflux (14.3%), 13 had Grade III reflux (62%), 5 had Grade IV reflux (24%), and 1 had Grade V reflux (4.7%). Nineteen ureters required one injection while one ureter required two injections. There were no intraoperative nor postoperative complications noted.

CONCLUSION: At the National Kidney and Transplant Institute, endoscopic treatment of VUR with Deflux for primary VUR demonstrated a cure rate of 90%, with no associated perioperative morbidity.

Human ; Male ; Female ; Child ; Child Preschool ; Infant ; deflux ; Endoscopy ; Vesico-Ureteral Reflux-treatment, therapy, management, drug therapy ; Urinary Bladder Diseases ; dextranomer ; dextranomer-hyaluronic acid copolymer

Bone formation in the urinary tract is a rare phenomenon. Osseous metaplasia in the kidney which presented as a pelvolithiasis is presented in this case. The patient consulted with a complaint of left subcostal mass. Ultrasound revealed nephrolithiasis with hydronephrosis of the left kidney while CT stonogram revealed staghorn calculus with hydronephrosis. Subsequently, left nephrectomy was performed. Grossly, the kidney was enlarged to 11.5m x 5cm x 3cm on cut section with an intrarenal mass measuring 7cm x 6.5cm x 6cm composed of tan gray irregular hard tissue. Histopathologically, the renal mass consisted of benign compact and cancellous bone wherein osseous metaplasia was considered.
Osseous Metaplasia ; Heterotopic Bone Formation ; Bone Lithiasis ; Nephrolithiasis