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Endoscopic treatment of vesicoureteral reflux in children
C C Schulman1, J Simon, D Pamart
1Department of Urology, University Clinics of Brussels, Erasme Hospital, Belgium.
Insights
Endoscopic injection of polytetrafluoroethylene (Teflon) successfully treated vesicoureteral reflux in children. This minimally invasive procedure offers a reliable alternative to surgery, reducing hospital stays with no reported complications.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Urologic Endoscopy
Background:
- Vesicoureteral reflux (VUR) affects numerous children, potentially leading to kidney infections and damage.
- Traditional surgical reimplantation for VUR involves significant hospital stays and potential complications.
- Endoscopic treatments offer a less invasive approach to managing VUR.
Purpose of the Study:
- To evaluate the efficacy and safety of endoscopic polytetrafluoroethylene (Teflon) injection for treating pediatric vesicoureteral reflux (VUR).
- To assess the long-term success rates of this minimally invasive VUR treatment.
- To compare the outcomes with traditional surgical methods.
Main Methods:
- 35 children with varying grades of VUR underwent endoscopic injection of polytetrafluoroethylene (Teflon) submucosally.
- A total of 51 ureters with reflux were treated.
- Post-procedure cystograms and 3-to-12-month follow-ups were used to assess reflux absence.
Main Results:
- Immediate post-procedure cystograms showed absence of reflux in all treated ureters.
- At 3-12 months follow-up, 32 out of 51 ureters remained free of reflux.
- Recurrence occurred in 4 ureters (3 low-grade), with 3 successfully retreated endoscopically and 1 requiring reimplantation.
Conclusions:
- Endoscopic polytetrafluoroethylene (Teflon) injection is a simple and reliable method for treating pediatric VUR.
- The procedure effectively avoids major surgery, reduces hospital stay, and has a favorable safety profile.
- This technique presents a viable, minimally invasive option for managing VUR in children.
Abstract:
We treated 35 children with different grades of vesicoureteral reflux with endoscopic injection of polytetrafluoroethylene (Teflon) behind the intravesical ureter. A total of 51 refluxing ureters was treated. In all cases absence of reflux was noted on a cystogram performed immediately after the procedure. At 3 to 12-month followup reflux was absent in 32 ureters and it recurred in 4, including 3 ureters with low grade reflux. A second injection of polytetrafluoroethylene in 3 ureters resulted in its absence, while in 1 case reimplantation was performed. The procedure is simple and reliable. An operation is avoided, hospital stay is reduced and no complications have occurred.