Clinical Consult: Weighing the risks and benefits of Deflux for reflux

vesicoureteral reflux VUR deflux Dx/HA

It’s estimated that one in three children with recurrent urinary tract infections have vesicoureteral reflux (VUR), a urological condition where urine flows backwards from the bladder to the kidney.

Though the condition’s management has evolved, the question of which treatment is the preferred one — and specifically, whether urologists should continue to turn to endoscopic injections of dextranomer/hyaluronic acid copolymer (Dx/HA, aka Deflux) — remains a source of debate.

Boston Children’s Urologist-in-Chief, David Diamond, MD and colleagues Alan B. Retik, MD and Stuart B. Bauer, MD, researched Dx/HA use, and determined that due to its:

  1. high failure rate
  2. long-term complication rate
  3. high re-treatment rate
  4. high (and rising) cost

the risks of Dx/HA far outweigh its limited benefits in a majority of patients.

Read Boston Children’s “Caution in Employing Deflux for Reflux – The Thinking Behind Our Approach” white paper and find out why our urology experts say Dx/HA should not be considered as a preferred treatment option for children with VUR.

One thought on “Clinical Consult: Weighing the risks and benefits of Deflux for reflux

  1. Dear Dr D. Diamond

    I just read your note about the utility of Dx/HA, I agree totally with your comments. I sent few months ago to J Urol and J Pediat Urol an article talking about this topic and they rejected then, I don`t know why?. My experience in our center is that when we performed a VCUG 5 years after intitial successful treatment there’s a relapse VUR un more than 20% of ureters. The initial successful rate after one or two treatemts was 84% (n=228), but the majority of patients has no late follow-up, but in our series we have 94 patients with more than 3 years of follow-up with a late VCUG, the majority of then are asymptomatic but there’s a relapsed VUR in 20%.

    I would like to know if you Dept has long-term follow-up

    Kind Regards

    Dr. L. García-Aparicio, MD, PhD, FEBPS.

    Pediatric Urology Div. Pediatric Surgery Dept.

    Hospital Sant Joan de Deu. Universitat de Barcelona

    Passeig Sant Joan de Déu 2

    08950 BARCELONA-SPAIN

    email: lgarcia@hsjdbcn.org

    Telf: +34932532156

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