[Investigation of long-term follow up after endoscopic operation for vesicoureteral reflux]

Results with respect of the state of the infused agent and the cause of unsuccessful outcome were examined in patients who were followed for more than 5 years after endoscopic surgery for vesicoureteral reflux (VUR).

Of 259 ureters treated by TUI (Transurethral injection) after 1988, 41 ureters (29 patients) that were followed for more than 5 years postoperatively were investigated. In all patients, teflon paste had been infused. The intervals between surgery and study enrollment ranged from 5 to 10 years, with a mean of 5.1 years.

After TUI was performed once, reflux disappeared in 30 (73%) of 41 ureters. The intervals between the detection of relapse and additional surgery ranged from 1 to 18 months, with a mean of 6.5 months. In 10 of 11 ureters with relapse, relapse was detected within one year after the initial surgery. When the presence or absence of reflux was examined at the final evaluation, there was no relapse in 34 of 39 ureters, with a mean postoperative follow-up of 5.9 years. Teflon paste could be sufficiently confirmed in 34 of 39 ureters excluding patients in whom TUI was changed to invasive surgery. However, this agent could not be confirmed in 5 ureters during follow-up.

Teflon paste was not confirmed by bladder echo in any patient showing an unsuccessful outcome, suggesting that success or failure in this procedure depends on the persistence of paste.