Clinical Value of Persistent but Downgraded Vesicoureteral Reflux after Dextranomer/Hyaluronic Acid Injection in Children

• Published in: Journal of Korean medical science Vol. 28; no. 7; pp. 1060 - 1064
• Main Authors: Baek, Minki, Kang, Min Young, Lee, Hahn-Ey, Park, Kwanjin, Choi, Hwang
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.07.2013; 대한의학회
• Subjects: Antibiotic Prophylaxis; Child; Child, Preschool; Dextrans - therapeutic use; Female; Fever - complications; Fever - epidemiology; Humans; Hyaluronic Acid - therapeutic use; Incidence; Male; Original; Retrospective Studies; Treatment Outcome; Urinary Tract Infections - complications; Urinary Tract Infections - drug therapy; Urinary Tract Infections - epidemiology; Vesico-Ureteral Reflux - drug therapy; Vesico-Ureteral Reflux - surgery; 의학일반; Pediatrics; Vesico-Ureteral Reflux; Endoscopy; Pyelonephritis
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2013.28.7.1060

We aimed to investigate the clinical value of persistent but downgraded vesicoureteral reflux (VUR) after dextranomer/hyaluronic acid (Dx/HA) injection in children. The medical records of 128 children (195 ureters) who underwent Dx/HA injections for VUR were reviewed. The incidences of pre- and post-operative febrile urinary tract infections (UTIs) were analyzed in children with or without persistent VUR on voiding cystourethrography (VCUG) 3 months postoperatively. The surgical results of VUR persistent children who underwent a single additional injection were assessed. The VUR resolved completely in 100 ureters (51.3%), was persistent in 95 ureters, and newly developed in 2 ureters. The incidence of pre/post-operative febrile UTIs were 0.35 ± 0.39 per year and 0.07 ± 0.32 per year in VUR resolved children (P < 0.001), and 0.76 ± 1.18 per year and 0.20 ± 0.61 per year in VUR persistent children (P < 0.001). A single additional Dx/HA injection (44 ureters) resolved VUR in 29 ureters (65.9%), and also reduced the VUR to grade I in 7 ureters (15.9%), II in 4 (9.1%), and III in 4 (9.1%). Even in children with persistent VUR after Dx/HA injection, the incidence of febrile UTIs decreased markedly. The VUR grade significantly decreases after single additional Dx/HA injection.