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'Sting' procedure in the treatment of secondary reflux in children
D Aubert1, G Zoupanos, O Destuynder
1Department of Pediatric Surgery, University of Franche-Comté, St. Jacques Hospital, Besançon, France.
Insights
Endoscopic subureteral injection of Teflon paste successfully treated secondary vesicoureteral reflux in 18 of 24 children. This minimally invasive technique offers an attractive alternative to open surgery for complex cases.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Endourology
Background:
- Secondary vesicoureteral reflux (VUR) presents complex management challenges in children.
- Traditional open surgical reimplantation for VUR can involve significant morbidity.
- Identifying effective, less invasive treatment options for secondary VUR is crucial.
Purpose of the Study:
- To evaluate the efficacy of endoscopic subureteral Teflon paste injection for correcting secondary VUR in pediatric patients.
- To assess outcomes across various etiologies of secondary VUR, including reimplantation failure, ureterocele, and bladder exstrophy.
- To compare the 'sting' technique with open surgical approaches.
Main Methods:
- A retrospective review of 24 children (31 refluxing ureters) treated with endoscopic subureteral Teflon paste injection.
- Analysis of success rates based on the underlying cause of secondary VUR.
- Detailed commentary on the specific technical aspects for each etiological category.
Main Results:
- Successful treatment of secondary VUR was achieved in 18 out of 24 cases (66.7% success rate).
- The 'sting' technique demonstrated effectiveness across diverse secondary VUR causes.
- The procedure avoided the complexities and complications associated with open surgery.
Conclusions:
- Endoscopic subureteral Teflon paste injection is a viable and effective treatment for secondary vesicoureteral reflux in children.
- This minimally invasive approach offers a favorable alternative to open surgery, particularly in challenging cases.
- The 'sting' technique provides a valuable option for managing complex pediatric VUR, reducing surgical burden.
Abstract:
The authors present their experience (24 children) with the endoscopic subureteral injection of Teflon paste in the correction of secondary vesicoureteral reflux: reimplantation failure; ureterocele; obstructive bladder; exstrophy; postchemocystitis, and Hutch's diverticulum. Of these 24 cases (31 refluxing ureters), 18 were treated with success. Each cause justifies a comment on the particularities of its endoscopic treatment. The 'sting' can be particularly attractive to cure secondary reflux, avoiding the difficulties and complications of open surgical reimplantation.