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Polytef paste injection of refluxing duplex ureters
1Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
Insights
Endoscopic injection of polytetrafluoroethylene (PTFE) paste successfully treated refluxing duplex ureters in children. Most patients showed resolved or reduced reflux, with one developing obstruction.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Ureteral Reflux Management
Background:
- Refluxing duplex ureters in children present a significant clinical challenge.
- Endoscopic injection is a minimally invasive option for managing vesicoureteral reflux (VUR).
Purpose of the Study:
- To evaluate the efficacy of endoscopic polytetrafluoroethylene (PTFE) paste injection for treating refluxing duplex ureters in pediatric patients.
- To assess the outcomes and potential complications associated with this minimally invasive procedure.
Main Methods:
- Thirty-four children with 35 refluxing duplex ureters underwent endoscopic injection of PTFE paste.
- Follow-up included assessment of reflux resolution, reduction in reflux grade, and monitoring for complications.
Main Results:
- Successful reflux resolution or significant reduction was observed in 28 out of 32 (87.5%) followed patients.
- Twenty-one patients (65.6%) ceased refluxing, while 7 (21.9%) showed a significant reduction in reflux grade.
- One patient (3.1%) experienced ureteric obstruction; contralateral single system reflux resolved in 8 patients.
Conclusions:
- Endoscopic PTFE paste injection is an effective treatment for refluxing duplex ureters in children, offering high success rates.
- The procedure demonstrates a favorable safety profile, with minimal complications reported.
- This technique also appears effective in resolving concurrent contralateral single system reflux.
Abstract:
Thirty-four children with 35 refluxing duplex ureters were treated by the endoscopic injection of polytetrafluoroethylene paste. Of the 32 patients followed, 21 ceased refluxing, 3 were unchanged and 7 had a significant reduction in the grade of reflux. One patient developed a ureteric obstruction. Concurrently, contralateral single system reflux was resolved in the 8 patients in whom it was present.