Therapy reduces UTIs in kids with vesicoureteral reflux

Hyaluronic acid/dextranomer gel (Deflux) reduced by 62% the incidence of recurrent urinary tract infections in children with vesicoureteral reflux, according to a study published in the Journal of Laparoendoscopic & Advanced Surgical Techniques (2007; 17:353-9). The therapy also eliminated the need for prophylactic antibiotics in 87% of patients.

“In this study, we see that Deflux is not only effective in resolving VUR, but also in reducing the incidence of UTIs and use of antibiotics, which require long-term compliance and can increase the potential of resistance,” said co-author Kevin P. Moriarty, MD, of Tufts University School of Medicine, Boston. “These data add to the growing body of evidence supporting it as first-line treatment for VUR.”

The study team reviewed charts of 100 children, ages 1 to 17 years, with VUR at Baystate Children’s Hospital in Springfield, MA. Inclusion criteria included grades II-IV VUR with breakthrough UTIs, despite prophylactic antibiotics. Success was defined as the resolution of reflux on a 3-month postoperative voiding cystourethrogram, and all patients were kept on prophylactic antibiotics for 3 months after injection.

After treatment with the gel, 13% of patients had recurrent UTIs compared with 75% before treatment, with a five-fold reduction in the incidence of UTIs per year (p=.001) post-treatment. It also eliminated the need for prophylactic antibiotics in 87% of patients. Of the 13 patients with recurrent UTIs after treatment, eight experienced them when they were no longer taking antibiotics.

The overall success rate by ureter of this treatment in resolving VUR was 77.4% after the first injection and 83.9% after a second injection. No major intraoperative or postoperative complications were reported.