Clinical Value of Persistent but Downgraded Vesicoureteral Reflux after Dextranomer/Hyaluronic Acid Injection in Children.
10.3346/jkms.2013.28.7.1060
- Author:
Minki BAEK
1
;
Min Young KANG
;
Hahn Ey LEE
;
Kwanjin PARK
;
Hwang CHOI
Author Information
1. Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Vesico-Ureteral Reflux;
Endoscopy;
Pyelonephritis;
Pediatrics
- MeSH:
Antibiotic Prophylaxis;
Child;
Child, Preschool;
Dextrans/*therapeutic use;
Female;
Fever/complications/epidemiology;
Humans;
Hyaluronic Acid/*therapeutic use;
Incidence;
Male;
Retrospective Studies;
Treatment Outcome;
Urinary Tract Infections/complications/drug therapy/*epidemiology;
Vesico-Ureteral Reflux/*drug therapy/surgery
- From:Journal of Korean Medical Science
2013;28(7):1060-1064
- CountryRepublic of Korea
- Language:English
-
Abstract:
We aimed to investigate the clinical value of persistent but downgraded vesicoureteral reflux (VUR) after dextranomer/hyaluronic acid (Dx/HA) injection in children. The medical records of 128 children (195 ureters) who underwent Dx/HA injections for VUR were reviewed. The incidences of pre- and post-operative febrile urinary tract infections (UTIs) were analyzed in children with or without persistent VUR on voiding cystourethrography (VCUG) 3 months postoperatively. The surgical results of VUR persistent children who underwent a single additional injection were assessed. The VUR resolved completely in 100 ureters (51.3%), was persistent in 95 ureters, and newly developed in 2 ureters. The incidence of pre/post-operative febrile UTIs were 0.35 +/- 0.39 per year and 0.07 +/- 0.32 per year in VUR resolved children (P < 0.001), and 0.76 +/- 1.18 per year and 0.20 +/- 0.61 per year in VUR persistent children (P < 0.001). A single additional Dx/HA injection (44 ureters) resolved VUR in 29 ureters (65.9%), and also reduced the VUR to grade I in 7 ureters (15.9%), II in 4 (9.1%), and III in 4 (9.1%). Even in children with persistent VUR after Dx/HA injection, the incidence of febrile UTIs decreased markedly. The VUR grade significantly decreases after single additional Dx/HA injection.
