Abstract | PURPOSE: MATERIALS AND METHODS: We performed a retrospective chart review of all children from 2002 to 2006 diagnosed with grades I to IV vesicoureteral reflux who were treated with Deflux and who had a negative initial followup voiding cystourethrogram at 2 to 5 months. Patients were categorized into post- Deflux infection and infection-free groups. Predictive factors, including the number of preoperative febrile urinary tract infections, dysfunctional elimination and renal cortical defects on dimercapto- succinic acid scan, were analyzed and compared. RESULTS: Of the patients 45 met all study inclusion and exclusion criteria. A total of 12 patients (27%) who were diagnosed with a culture documented febrile urinary tract infection were categorized into the infection group. Of 12 children in the post- Deflux infection group 11 (92%) had multiple predictors compared to 14 of 33 (42%) who remained infection-free (p = 0.005). Ten of these 12 patients (92%) were found to have evidence of vesicoureteral reflux when evaluated with voiding cystourethrogram/ radionuclide cystogram after infection. CONCLUSIONS: This study demonstrates that up to 27% of patients treated endoscopically may have a febrile urinary tract infection after an initial negative postoperative voiding cystourethrogram/ radionuclide cystogram at 2 to 5 months and up to 92% of those will demonstrate delayed vesicoureteral reflux recurrence. Children with a history of 2 or more predictive factors, including multiple febrile urinary tract infections, dysfunctional elimination and/or renal cortical defects on dimercapto- succinic acid scan, may not be optimal candidates for Deflux. If endoscopic treatment is chosen, these patients require more vigilant followup, including late voiding cystourethrogram.
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Authors | Sherry Sedberry-Ross, Dana C Rice, Hans G Pohl, A Barry Belman, Massoud Majd, H Gil Rushton |
Journal | The Journal of urology
(J Urol)
Vol. 180
Issue 4 Suppl
Pg. 1605-9; discussion 1610
(Oct 2008)
ISSN: 1527-3792 [Electronic] United States |
PMID | 18710762
(Publication Type: Journal Article)
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Chemical References |
- Dextrans
- deflux
- Hyaluronic Acid
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Topics |
- Dextrans
(administration & dosage)
- Endoscopy
- Female
- Fever
(epidemiology)
- Humans
- Hyaluronic Acid
(administration & dosage)
- Male
- Prostheses and Implants
- Prosthesis Implantation
(methods)
- Recurrence
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Urinary Tract Infections
(epidemiology)
- Vesico-Ureteral Reflux
(therapy)
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