Endoscopic treatment of vesicoureteric reflux with collagen. Five years' experience

Submucosal injections of bovine collagen (Zyplast) were administered to 67 children and 7 adults with 115 refluxing ureters. Reflux was grade I in 14 ureters, grade II in 54, grade III in 38 and grade IV in 9. All patients had a history of recurrent urinary infection. One year after treatment 70 ureters showed no reflux, 20 were grade I and 25 showed a complete recurrence. The cure rate was 81% if grade I recurrence is included. In all, 68 ureters were followed up for 2 to 4 years. In 19 ureters a second injection was given, 47 showed no reflux, 19 had grade I reflux and 2 had a recurrence. In 5 ureters reflux grade I disappeared without a second injection. The cure rate was 97%. Renal scarring was seen in 4 kidneys. Collagen injections are an adequate method of treatment for reflux grades I-III.