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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:
- high failure rate
- long-term complication rate
- high re-treatment rate
- 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.
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