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Endoscopic correction of vesicoureteric reflux in failed reimplanted ureters
1Children's Research Centre, Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland.
Purpose:
Persistent vesicoureteral reflux (VUR) after reimplantation of ureters requiring reoperation has been reported in up to 7.5% of cases. We report our experience with endoscopic subureteric Teflon injection (STING) in the treatment of VUR after failure of reimplantation of ureters.
Materials And Methods:
Between 1985 and 1995, 31 children (18 male, 13 female) with persistent high-grade VUR after failure of reimplantation of ureters were referred to our hospital for endoscopic correction of VUR. The reflux was unilateral in 22 and bilateral in 9 (40 refluxing units). The ages at the time of STING ranged from 2 to 14 years. Ultrasound and voiding cystourethrography was performed in all patients at 3 months, 1 year and 3 years after STING procedure. Patients were followed-up for periods ranging from 1 to 11 years.
Results:
VUR was successfully corrected in 27 ureters after a single injection. Seven ureters required two injections and 4 ureters three injections for the correction of reflux. Failure to correct reflux was noted in 2 ureters and these were corrected by reoperation.
Conclusions:
STING is a simple and effective day care procedure for the correction of VUR after failure of reimplantation of ureters.