ESPN 51th Annual Meeting

ESPN 2018


 
Deflux in the treatment of vesicoureteral reflux
ABIR BOUSSETTA YOSRA HAMMI MERIEM FERJANI ONS NAIJA MANEL JELLOULI YOUSSEF GHARBI TAHER GARGAH NEJIB KAABAR

 
Introduction:

 

Vesicoureteral reflux (VUR) is the most common uropathy among children. Its therapeutical-handling can face various issues depending from the grade, laterality and age of the patient. Endoscopic treatment by submucosal injection of Deflux is one of the cures for VUR. The aim of this work was to study the indications, advantages and limits of the endoscopic treatment with Deflux.

Material and methods:

 

It was a retrospective study about a group of 30 patients corresponding to 47 ureteral units treated with Deflux injections, regularly followed at the pediatric nephrology department in Charles Nicolle hospital and pediatric surgery department in Habib Thameur Hospital in Tunis during a period of 2 years (2015-2017).

Results:

 

The mean age was 5.5 years old (sex ratio:0.9). a single injection cured the reflux in 47% of patients and 57.5% of ureters. A higher success-rate was observed in patients of 5 years or older (p0.005), girls (p=0.0095) and low grades (p<0.001). Volumes≤0.5 cc were correlated with more success rates, although it wasn’t statistically significant (p=0.27).

Endoscopic treatment with Deflux appears to be effective and well tolerated for the treatment of VUR associated with bladder dysfunction. The incidence of febrile urinary tract infections was reduced from 93.3% to 6.6% after Deflux injection. No post-operatory complications were noticed except from fever and urine retention in one case each and both were transitory.

Conclusions:

 

Endoscopic sub-ureteral injection of Deflux for children with VUR appears to be treatment of choice for VUR including high grade and complex cases. It is currently considered as a valuable treatment option. It seems to be an effective and safe treatment with a low rate complication. Morbidity of Deflux should be evaluated in long and midterm.