Ces Urol 2008, 12(3):199-204 | DOI: 10.48095/cccu2008021

Deflux® in the treatment of high-grade vesicoureteral reflux in the smallest children

Zdeněk Dítě^1,2,3, Radim Kočvara^1,2, Jan Langer⁴, Josef Sedláček¹, Jaroslav Molčan¹, Jan Dvořáček^1,2,3

¹ Urologická klinika 1. LF UK a VFN, Praha

² Subkatedra dětské urologie IPVZ, Praha

³ Katedra urologie l. LF UK, Praha

⁴ Klinika dětského a dorostového lékařství 1. LF UK a VFN, Praha

Aim: We evaluate and compare in prospective randomised study results of treatment of high grade vesicoureteric reflux (VUR) of the smallest children using endoscopic miniinvasive instillation of Deflux® and conservative antibiotic treatment.

Material and methods: Twenty two children 1 - 40 months old (φ 22,9 months) underwent instillation of Dx/Ha (Deflux®) for VUR grade 3 - 32 (φ 13,5 months) were treated conservatively. Postoperative videourodynamic study was performed to evaluate the treatment results together with lower urinary tract function, and ultrasound investigation (exclusion of obstructive megaureter) in operated group respectively.

Results: There were 22 children controlled after Dx/Ha instillation. The children were followed for 11 - 24 months. VUR was cured in 12 cases (54,5%) and improved (grade 1 - 2) in five children (22,7%). In conservative group there were five (22,7%) children completely cured and next four (18,2%) improved (VUR gr 1 - 2). All children absolved the treatment without any complications, excluding one case with obstructive megaureter after pyelonephritis diagnosed, which was cured by temporarily inserted JJ stent.

Conclusion: According to our experiences the endoscopic miniinvasive instillation therapy represents safe and ef ective alternative of VUR treatment in all age groups with good therapeutical outcome and minimum of adverse reactions.

Keywords: vesicoureteral reflux, endoscopic transurethral instillation, antibacterial chemophrofylaxis, Deflux®

Received: October 7, 2008; Accepted: October 20, 2008; Published: June 1, 2008