Introduction:

Endoscopic management of vesicoureteric reflux (VUR) has gained great popularity over the last few decades. Deflux injection has shown good results regarding the prevention of Febrile UTI (FUTI) and decreasing the morbidity of the surgical management of VUR. We suspected that patients who present with FUTI earlier in life were more likely to require repeated Deflux injections when compared to those presented at an older age.

Methods:

The charts of refluxing patients who presented with UTI from 2010 to 2018 were retrospectively reviewed. Two groups were created according to the number of Deflux injections (Single-injection vs. repeated injections). We collected patients’ gender, side, laterality, and the grade of VUR. Moreover, we recorded the number of Deflux injections. We excluded patients who presented with antenatal hydronephrosis, neurogenic bladder and follow up less than one year after the first injection. Repeated Deflux injection was indicated if patients experienced recurrent FUTI postoperatively and documented VUR.

Results:

We included 173 patients with 260 units. 203 renal units (78.1%) underwent a single injection and 57 units (21.9%) had repeated injections. Patients’ characteristics are demonstrated in table 1. Of the repeated group, 41 units (71.9%) received 2 Deflux injections, 11 units (19.3%) were injected 3 times and the remaining 5 units underwent 4 injections. Within the same VUR grade, the age at presentation was not significantly different between both groups (Figure 1). Interestingly, 28/57units (49.1%) with repeated injection presented before the age of one year in comparison to 70/203 units (34.5%) with a single injection (p=0.04).

Conclusions:

22% of included renal units underwent repeated Deflux injections. More than forty per cent of units with repeated injections had Grade 4-5 VUR. Patients with VUR presented with FUTI before the age of one year old were at higher risk of repeated Deflux injections than those who presented later.