✦ VUR Treatment

Endoscopic STING / HIT Procedure (Deflux injection)

Q: How successful is Deflux injection for VUR?

Single injection success rates are 70–80% for grade II–III VUR; success decreases for grade IV–V disease where reimplantation may be preferable.

Q: What happens if the Deflux injection does not work?

If VUR persists after 1–2 injections, open, laparoscopic, or robotic reimplantation is recommended as the definitive treatment. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Q: Does the Deflux material stay permanently?

Deflux is gradually absorbed over years; the scar tissue it induces maintains the anti-reflux effect even after the bulking agent dissolves.

Minimally Invasive Endoscopic Injection to Correct Vesicoureteral Reflux

15–30 min PROCEDURE

Day Care HOSPITAL STAY

70–80% SUCCESS RATE

1–2 Days RECOVERY

What is Endoscopic STING / HIT Procedure (Deflux injection)?

The STING (Subureteric Transurethral Injection) and HIT (Hydrodistension Implantation Technique) procedures inject a bulking agent (Deflux — dextranomer/hyaluronic acid) submucosally at the ureteric orifice via cystoscope, creating a mound that narrows the ureteric orifice and restores the anti-reflux mechanism. It is a day-case procedure under brief general anaesthesia with minimal discomfort, suitable as first-line surgical management for grades II–IV VUR before considering reimplantation. The procedure is performed under general or spinal anaesthesia with a hospital stay of Day Care. Success rates reach 70–80% in appropriately selected patients at experienced centres.

Children with grades II–IV VUR causing recurrent pyelonephritis unresponsive to antibiotics, or those where antibiotic prophylaxis is poorly tolerated. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Cystoscopy

Cystoscopy performed under brief general anaesthesia.

Orifice Identification

Ureteric orifice identified; catheter or needle positioned submucosally at the target site.

Deflux Injection

Deflux (dextranomer/hyaluronic acid) injected creating a subureteral mound to restore the anti-reflux mechanism.

Mound Assessment

Mound configuration assessed — volcano appearance at HIT technique confirms correct placement.

Discharge & Follow-up

Cystoscope withdrawn; patient discharged same day; imaging follow-up at 3 months to confirm resolution.

Outcomes

15–30 minDURATION

Day CareHOSPITAL STAY

70–80%SUCCESS RATE

1–2 DaysFULL RECOVERY

Who Needs This Treatment?

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Simplest surgical treatment for VUR — 15-minute day-case procedure.
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No incision or catheter required — truly minimally invasive.
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First-line surgical option before considering open reimplantation.
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70–80% success rate for grades II–III VUR.
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Can be repeated if first injection is partially successful.
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Avoids anaesthetic risks and recovery of open surgery.

"Deflux injection is our first-line surgical option for VUR — a 15-minute day-case procedure with 75% success. If it works, the child avoids a major operation; if it doesn't, we move to reimplantation with confidence."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked Questions

How successful is Deflux injection for VUR?+

What happens if the Deflux injection does not work?+

Does the Deflux material stay permanently?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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