Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
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Long-term Results of Endoscopic Deflux$^{(R)}$ Injection for Vesicoureteral Reflux in Children

  • Kim, Hwanik (Department of Urology, Seoul National University College of Medicine) ;
  • Kim, Byung Soo (Department of Urology, Seoul National University College of Medicine) ;
  • Cheong, Hae Il (Department of Pediatrics, Seoul National University Children's Hospital) ;
  • Cho, Byoung Soo (Department of Pediatrics, School of Medicine, Kyung Hee University) ;
  • Kim, Kwang Myeong (Department of Urology, Seoul National University College of Medicine)
  • Received : 2015.03.31
  • Accepted : 2015.04.25
  • Published : 2015.04.30
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Abstract

Purpose: We evaluated the long-term results of endoscopic Deflux$^{(R)}$ 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$^{(R)}$ 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$^{(R)}$ 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$^{(R)}$ 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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References

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