The Efficacy of Two Different Injection Materials (Dextranomer/Hyaluronic Acid) in the Treatment of Vesicoureteral Reflux: Single-Surgeon, Single-Centre Experience

Objective: This study aimed to compare the efficacy of 2 different dextranomer/cross-linked hyaluronic acid materials in the treatment of children diagnosed with vesicoureteral reflux (VUR). Material and Methods: Between 2017 and 2025, 35 children (51 renal units) diagnosed with VUR by voiding cystourethrography and suitable for endoscopic subureteric injection therapy were included in this single-centre, observational study. The injection materials used were Hyadex (80-250 µm dextranomer microparticles in non-animal stabilised cross-linked hyaluronic acid) and Dexell (80-120 µm dextranomer microspheres). All procedures were performed by a single surgeon. Postoperative follow-up included clinical and ultrasonographic evaluation for 3-6 months. Results: The study group included 19 boys and 16 girls, with a mean age of 6.4 years. Bilateral reflux was present in 16 patients, right-sided in 10, and left-sided in 9. Reflux grades among renal units were: Grade I (5), Grade II (18), Grade III (10), Grade IV (8), and Grade V (8). The Dexell group consisted of 22 patients (32 renal units), and the Hyadex group of 13 patients (19 renal units). No postoperative urinary tract infection or hydronephrosis progression was observed. Ureteroneocystostomy was required in 5 patients (7 renal units) with persistent reflux. No significant difference in clinical outcomes was found between the 2 groups. Conclusion: Endoscopic subureteric injection is a safe and effective method in appropriately selected VUR patients. There was no significant difference in postoperative outcomes between the Hyadex and Dexell groups.