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Removal of an Intravesical Gellhorn Pessary and Staged Repair of a Residual Large Vesico-Vaginal Fistula
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Removal of an Intravesical Gellhorn Pessary and Staged Repair of a Residual Large Vesico-Vaginal Fistula

Published on: April 14, 2026

Use of collagen for endoscopic correction in complicated vesicoureteral reflux

Tsan Jung Yu1, Li Ching Chang

  • 1Departments of Urology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. ed100622@edah.org.tw

Scandinavian Journal of Urology and Nephrology
|March 17, 2007
PubMed

Insights

Endoscopic subureteral injection of collagen (STING) is an effective treatment for complicated vesicoureteral reflux (VUR) in children. This minimally invasive approach offers a safe alternative to antibiotics and surgery, with high success rates and no observed obstruction.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Endourology

Background:

  • Vesicoureteral reflux (VUR) in children often requires intervention beyond antibiotic prophylaxis or open surgery.
  • Endoscopic treatments offer a less invasive alternative for managing VUR.

Purpose of the Study:

  • To evaluate the efficacy and safety of endoscopic subureteral injections of collagen (STING) for treating complicated pediatric VUR.
  • To assess STING as a primary treatment option for complex VUR cases.

Main Methods:

  • A modified STING procedure was performed on 25 children (41 ureteral units) with various complex VUR conditions.
  • Patients had conditions including Hutch's diverticulum, duplex systems, ureteroceles, and ectopic ureters, with VUR grades III-V.
  • Follow-up included voiding cystourethrograms, and imaging (IV pyelography or sonography) to assess for obstruction.

Main Results:

  • Successful treatment was achieved in 34 out of 41 refluxing units (83%).
  • Regression or downgrading of VUR occurred in seven units.
  • No urinary tract obstruction was detected post-procedure during follow-up.

Conclusions:

  • Endoscopic correction using modified STING is a viable first-line treatment for complicated VUR in children.
  • Individualized technique modification is crucial for optimizing outcomes in diverse VUR presentations.
Abstract

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