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Clinical value of persistent but downgraded vesicoureteral reflux after dextranomer/hyaluronic acid injection in children.

Abstract
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.
AuthorsMinki Baek, Min Young Kang, Hahn-Ey Lee, Kwanjin Park, Hwang Choi
JournalJournal of Korean medical science (J Korean Med Sci) Vol. 28 Issue 7 Pg. 1060-4 (Jul 2013) ISSN: 1598-6357 [Electronic] Korea (South)
PMID23853490 (Publication Type: Journal Article)
Chemical References
  • Dextrans
  • dextranomer
  • Hyaluronic Acid
Topics
  • Antibiotic Prophylaxis
  • Child
  • Child, Preschool
  • Dextrans (therapeutic use)
  • Female
  • Fever (complications, epidemiology)
  • Humans
  • Hyaluronic Acid (therapeutic use)
  • Incidence
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Urinary Tract Infections (complications, drug therapy, epidemiology)
  • Vesico-Ureteral Reflux (drug therapy, surgery)

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