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[Endoscopic treatment of vesicoureteral reflux]
J López López1, J Sánchez Zalabardo, M Sánchez Elipe
1Servicios de UrologíaServicios de UrologíaServicios de Urología. m.uroh@hcu.blesa.es
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Endoscopic treatment of vesicoureteric reflux in children using submucosal injection of polytetrafluoroethylene (Teflon) paste is highly effective. This minimally invasive technique offers a high success rate with reduced morbidity and shorter hospital stays compared to open surgery.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
Background:
- Vesicoureteric reflux (VUR) is a common condition in children.
- Traditional open surgery for VUR can be invasive with longer recovery times.
Purpose of the Study:
- To evaluate the efficacy and safety of endoscopic treatment for VUR in children.
- To assess the success rate of submucosal polytetrafluoroethylene (Teflon) injection for VUR.
Main Methods:
- A cohort of 22 children (30 VUR cases) aged 19 months to 8 years underwent subureteric Teflon paste injection.
- Procedures were performed under general anesthesia using a pediatric cystoscope.
- Postoperative follow-up included ultrasound and radionuclide cystography at 15 days, 6 months, and 1 year.
Main Results:
- The overall success rate for endoscopic treatment was 96.5%.
- 93.1% of patients required only one injection for successful treatment.
- No patients were hospitalized due to complications; one patient required open surgery after two failed injections.
Conclusions:
- Submucosal Teflon injection is a safe and effective first-line treatment for pediatric VUR.
- Endoscopic treatment demonstrates comparable success rates to open surgery with lower morbidity and reduced healthcare costs.
- Shorter hospital stays are a significant advantage of the endoscopic approach.
Aim:
We report our experience of the endoscopic treatment of vesicoureteric reflux in children by submucosal injection of polytetrafluoroethylene (Teflon).
Patients And Methods:
From April 1995 to September 1999 we treated 30 cases of vesicoureteric reflux in 22 children aged 19 months to 8 years. All the children underwent general anesthesia and subureteric injection of polytetrafluoroethylene paste with a pediatric cystoscope. Patients were discharged the day of the operation and were followed-up 15 days, six months and one year postoperatively with ultrasound and radionuclide cystography. When reflux persisted, the treatment was repeated.
Results:
Open surgery was performed in one patient with reflux after two repeat injections. Another patient underwent a second, successful, injection. The overall success rate with endoscopic treatment was 96.5% and only one injection was required in 93.1%. None of the patients required hospitalization because of complications due to the operation or the endoscopic technique.
Conclusions:
We consider submucosal injection of Teflon to be a first-line technique in the treatment of vesicoureteric reflux in children. The success rate is similar to that of open surgery but with endoscopic treatment morbidity and costs are lower and hospital stay is shorter.