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Multicenter survey of endoscopic treatment of vesicoureteral reflux using polytetrafluoroethylene

P Puri1, C Granata

  • 1Children's Research Centre, Our Lady's Hospital for Sick Children, Dublin, Ireland.

The Journal of Urology
|August 27, 1998
PubMed

Insights

Endoscopic subureteral polytetrafluoroethylene (Teflon) injection effectively treats pediatric vesicoureteral reflux in most cases. This safe, outpatient procedure demonstrates high success rates with minimal long-term complications.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Urologic Oncology

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children, increasing the risk of urinary tract infections and renal damage.
  • Endoscopic subureteral injection offers a minimally invasive alternative to surgical correction for VUR.

Purpose of the Study:

  • To evaluate the effectiveness, long-term outcomes, and safety of endoscopic subureteral polytetrafluoroethylene (Teflon) injection for treating pediatric VUR.
  • To assess the success rates across different grades of VUR and analyze recurrence and complication rates.

Main Methods:

  • A multicenter survey involving 53 pediatric urologists/surgeons from 41 centers worldwide.
  • Data collected via questionnaires on 12,251 ureters in 1,921 boys and 6,411 girls treated between 1984 and 1996.
  • Follow-up ranged from 1 to 13 years, with monitoring via voiding cystourethrography and renal ultrasound.

Main Results:

  • Successful reflux resolution after one injection in 75.3% of ureters; overall success rate (including improvement) reached 81.3%.
  • Failure to correct reflux occurred in 4.5% of cases, necessitating ureteral reimplantation.
  • Vesicoureteral junction obstruction developed in only 0.33% of ureters; no adverse effects attributed to polytetrafluoroethylene were reported.

Conclusions:

  • Endoscopic subureteral polytetrafluoroethylene injection is a simple, safe, and effective outpatient treatment for all grades of VUR in children.
  • The procedure demonstrates a high success rate and favorable long-term safety profile, supporting its widespread use.
Abstract

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