Ahmet Furkan ÖZSOY, Murat Can KARABURUN, Eralp KUBİLAY, Aykut AKINCI, Ahmet Doruk GÜLER, Yakup Tarkan SOYGÜR, Berk BURGU
Journal of Urological Surgery - 2026;13(2):114-120
Objective: This study aimed to compare the clinical and radiographic success rates of endoscopic treatment for vesicoureteral reflux (VUR) using two different formulations of dextranomer microspheres. Materials and Methods: This retrospective study included 119 children treated endoscopically for VUR between 2015 and 2020 at a single tertiary center. Subureteric injections were performed using either Dexell (n=61) or Deflux (n=58) by a single surgeon applying the hydrodistention implantation technique. Clinical data, including demographics, VUR grade, voiding status, injection volume, and complications, were collected from medical records. Treatment success was defined as the resolution of reflux on voiding cystourethrogram at 3 months, and the absence of febrile urinary tract infections during the 2- and 5-year follow-ups. Statistical analyses included chi-square and Mann-Whitney U tests, and logistic regression was used to identify predictors of treatment failure. Results: The mean follow-up durations were 75.9 months in the Dexell group and 78.2 months in the Deflux group, with comparable baseline demographic and clinical characteristics between groups. The short-term success rates at 3 months were 83.6% for Dexell and 84.5% for Deflux (p=0.896). Long-term success rates remained similar at both 2 years (80.3% vs. 81.0%, p=0.922) and 5 years (72.1% vs. 74.1%, p=0.805). Postoperative obstruction occurred in 3 patients in the Dexell group and 2 patients in the Deflux group, all of which resolved conservatively. Multivariable analysis revealed no independent predictors of treatment failure. Conclusion: Our analysis showed that the diameter of dextranomer microspheres, frequently utilized for the endoscopic treatment of pediatric VUR, did not affect the short-term or long-term success rates of the procedure. Therefore, Dexell may be considered a cost-effective alternative to Deflux in clinical practice. However, multicentric, randomized, prospective trials with long follow-up durations are necessary.
