Sunday, January 6, 2013

Injection therapy for vesicoureteral reflux notes 3

The mechanism of long-term sustained efficacy of dextranomer/hyaluronic acid (Deflux) is:
Dextranomer/hyaluronic acid is a dual component material. The dextranomer is cross-linked dextran microspheres 80 – 250 ยตm in diameter in a gel of hyaluronic acid. The dextranomer, the main bulking agent, is slowly degraded by hydrolysis. The hyaluronic acid represents the transport medium and slowly dissipates over 12 weeks. Volume stability over time results from fibroblast migration and collagen ingrowth into the hyaluronic acid matrix between the dextranomer microspheres. Stenberg et al found that histologic samples taken at the time of open reimplantation after failed injection therapy revealed granulomatous reaction of the giant cell type, inflammatory cell infiltration and implant pseudoencapsulation. 3

3. Stenberg A , Larsson E , Lackgren G . Endoscopic treatment with dextranomer/hyaluronic acid for vesicoureteral reflux: histological findings. J Urol 2003 ; 169 : 1109 – 13 .



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