Deflux injection is a medical procedure used to treat certain conditions involving the urinary system. This minimally invasive approach involves the injection of a specific gel-like substance. It is generally considered a less invasive option compared to traditional surgical methods.
Understanding Deflux Injection and Its Purpose
Deflux is a gel-like substance composed of dextranomer microspheres and hyaluronic acid, a naturally occurring sugar-based product. This biocompatible material is designed to remain in the body without migrating into surrounding tissues or organs. It is primarily used to treat vesicoureteral reflux (VUR), a condition where urine flows backward from the bladder into the ureters and sometimes up to the kidneys.
VUR occurs when the one-way valve at the junction of the ureter and bladder does not function correctly, allowing urine to reflux. This backward flow can lead to frequent urinary tract infections (UTIs), kidney scarring, and other complications if left untreated. VUR is typically diagnosed through tests such as a voiding cystourethrogram (VCUG), which visualizes the urine flow within the urinary tract.
Deflux acts as a bulking agent. When injected, the gel creates a mound at the ureteral opening into the bladder, which helps to strengthen the natural valve mechanism. This added bulk prevents the backward flow of urine, reducing the risk of UTIs and protecting the kidneys from potential damage. Deflux is often a treatment option for children with certain grades of VUR, especially when conservative management, such as antibiotic prophylaxis, has not been effective.
The Deflux Injection Procedure
Preparation for a Deflux injection typically involves specific instructions from the healthcare provider, which may include fasting for a certain period before the procedure. As the procedure is generally performed under general anesthesia, the medical team carefully reviews anesthesia type and dosage to ensure patient safety and comfort.
The Deflux injection procedure is performed using a cystoscope, a tiny fiber-optic camera attached to a narrow tube. The cystoscope is gently inserted through the urethra into the bladder, allowing visual inspection of the urethra, bladder, and ureteral openings. Sterile saline is used to fill the bladder, providing a clear view for the physician.
Once the ureteral junction is clearly visible, Deflux gel is injected into the tissue around the opening of the ureter. This creates the necessary bulk to correct the reflux. The procedure generally lasts 15 to 30 minutes. Immediate post-procedure care involves monitoring the patient in a recovery area for a brief period to ensure stable vital signs and address any immediate discomfort. Pain management is typically managed with over-the-counter pain relievers, and patients are usually discharged the same day.
Post-Procedure Recovery and Outcomes
Following a Deflux injection, patients may experience mild, temporary discomforts such as soreness, a stinging sensation when urinating, or bladder spasms for a day or two. Activity restrictions are usually minimal, with most individuals able to return to their usual activities within a day or two. Hydration is encouraged to help flush the bladder and minimize discomfort.
Follow-up appointments are typically scheduled around three months after the procedure to assess its effectiveness, often involving a repeat voiding cystourethrogram (VCUG). Success rates for Deflux injections range from 70% to 93% after a single injection, with higher success rates often seen in lower grades of VUR. Some patients, particularly those with higher grades of VUR, may require a second injection for complete resolution, with success rates potentially reaching 85.9% after two injections.
Though rare, complications can include blood in the urine, a new urinary tract infection, or persistent reflux requiring additional treatment. If Deflux is not successful after one or two injections, or if reflux recurs, other treatment options, such as open surgical ureteral re-implantation, may be considered. Long-term studies indicate the durability and effectiveness of Deflux treatment over 15 to 25 years, showing a low risk for recurrent UTIs or the need for further open surgery.