Abstract
Purpose: Vesicoureteral reflux (VUR) is a common urinary tract anomaly which occurs in approximately 0.4-1.0% of infants and is associated with recurrent UTIs that may result in renal scarring. The endoscopic treatments become an established alternative to long term antibiotic prophylaxis and open surgery. The aim of this study is to examine the use of an endoscopic injection technique, specifically the Hydrodistension implant technique (HIT procedure) using Nonanimal stabilized Hyaluronic acid/Dextranomer Gel (Deflux^[○!R]). Subject and Methods: A total 16 infants and children (25 ureters) with a median age of 2 years and 2 months (range 6 months to 5 years and 8 months) underwent the HIT procedure. The reflux was grade II in 4 ureters, Grade III in 9 ureters and grade IV in 12 ureters. DMSA scan demonstrated renal scarring in 13 (52%). Results: Vesicoureteral reflux completely resolved in 21 (84.0%) ureters after a single injection of Deflux. Four ureters (16.0%) required a 2nd injection and resolved. However, two patients were found to have recurrent reflux one year after injection. The final resolution rate at one year after injection was 88.8%. All patients underwent endoscopic procedure on an out-patient basis. There were no complications. Conclusion: Endoscopic treatment using Deflux is a safe and effective method for eradicating VUR, but long term follow up is required to discover late relapsing cases.
