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KMID : 0358320070480060620
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Korean Journal of Urology
2007 Volume.48 No. 6 p.620 ~ p.626
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Dextranomer/Hyaluronic Acid Copolymer(Deflux?) Injection for Vesicoureteral Reflux in Children: the Efficacy and Safety
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Park Yong-Hyun
Kim Kwang-Myung
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Abstract
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Purpose: We evaluated the efficacy and safety of Deflux injection for treating vesicoureteral reflux(VUR) in children.
Materials and Methods: Between January 2004 and May 2006, 49 children (28 boys and 21 girls) with a mean age of 51 months(5-182) underwent Deflux injection. VUR was unilateral in 19 cases(38.8%) and bilateral in 30(61.2%), affecting 79 ureters. VUR was grades II to V in 26 cases(32.9%), 24(30.4%), 16(20.3%), and 4(5.1%), respectively. Our clinical protocol involved ultrasonography at 6 weeks to evaluate the development of hydronephrosis and the creation of submucosal mound, and VCUG or RIVCU at 3 months to assess the VUR.
Results: The median follow-up was 8.0 months(1-22). The cure rate at 3 months by the ureter was 81.6%(88.9% for grade I, 100% for grade II, 79.2% for grade III, 75.0% for grade IV, and 50.0% for grade V) and the cure rate was 84.8% for the total patients(100% for the unilateral cases and 80% for the bilateral cases). There were 16 patients with 1 year of follow-up and the cure rate was 88.5% by the ureter and 87.5% for the total patient. The severity of VUR(p=0.035) and the concomitant voiding dysfunction(p=0.001) were the significant predictors of a successful outcome. One patient complained of gross hematuria resolved within a few days.
Conclusions: Deflux injection was safe and efficacious with a low complication rate. The severity of VUR and the concomitant voiding dysfunction had significant adverse effects on the cure rate.(Korean J Urol 2007;48: 620-626)
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KEYWORD
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Vesicoureteral reflux, Deflux, Minimally invasive surgical procedures
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