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Primary vesicoureteric reflux: treatment with subureteric injection of Polytef paste

N Davies1, J D Atwell

  • 1Wessex Regional Centre for Paediatric Surgery, Southampton General Hospital.

British Journal of Urology
|May 1, 1991
PubMed

Insights

Endoscopic subureteric injection of polytetrafluoroethylene paste (Polytef) offers an 80% cure rate for pediatric refluxing ureters after two treatments. While effective and minimally invasive, long-term safety and efficacy require further investigation.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Biomaterials in Medicine

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children, potentially leading to kidney infections and damage.
  • Endoscopic treatment offers a less invasive alternative to surgery for VUR.

Purpose of the Study:

  • To evaluate the efficacy and safety of endoscopic subureteric injection of polytetrafluoroethylene paste (Polytef) for treating primary VUR in children.
  • To determine the success rate and complication profile of this minimally invasive procedure.

Main Methods:

  • A cohort of 34 children with 40 primary refluxing ureters underwent endoscopic subureteric injection of Polytef.
  • Injected volumes ranged from 0.1 to 0.8 ml (mean 0.3 ml).
  • Success was defined as complete resolution of reflux; a second injection was permitted if needed.

Main Results:

  • A single injection successfully treated reflux in 26 ureters (65%).
  • Reflux grade improved in 9 additional ureters.
  • An overall cure rate of 80% was achieved after a second injection in 7 ureters.
  • One case of self-limiting ureteric obstruction was the sole complication.

Conclusions:

  • Subureteric Polytef injection is a quick, easy, and effective endoscopic treatment for pediatric VUR.
  • The procedure demonstrates a high initial success rate and an 80% overall cure rate after a second injection.
  • Long-term efficacy and safety of subureteric Polytef injection in children warrant further study and reservation.

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