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KMID : 1040420150190010031
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Childhood Kidney Diseases
2015 Volume.19 No. 1 p.31 ~ p.33
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Long-term Results of Endoscopic Deflux® Injection for Vesicoureteral Reflux in Children
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Kim Hwan-Ik
Kim Byung-Soo
Cheong Hae-Il
Cho Byoung-Soo
Kim Kwang-Myeong
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Abstract
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Purpose: We evaluated the long-term results of endoscopic Deflux® 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® 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® 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® 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.
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KEYWORD
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Vesicoureteral reflux, Deflux®, Endoscopic treatment, Children, Urinary tract infection
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