Endoscopic correction of primary vesicoureteric reflux by subureteric injection of polytetrafluoroethylene

Abstract

91 children (143 ureters) with primary vesicoureteric reflux (VUR) treated endoscopically by subureteric injection of 'Polytef' (polytetrafluoroethylene) paste were followed up for 2 to 5 1/2 years. 94% of the patients were treated as day cases. Reflux ceased in 113 (79%) of the 143 ureters after a single injection of polytef paste. 20% of ureters in this series required more than one endoscopic injection of polytef paste to correct reflux. Nearly 80% of the 113 ureters corrected after a single injection of polytef required less than 0.3 ml of paste per ureter to correct reflux. 88% of ureters continue to show absence of reflux 2 to 5 1/2 years after endoscopic correction. More than half of the recurrences were only of grade I or grade II severity and required no treatment. 7 ureters had recurrent grade III or IV reflux and were reinjected without any difficulty. The correction of vesicoureteric reflux by endoscopic injection of polytef paste is an outpatient procedure that requires 15 min of anaesthetic time. It is safe, simple, and effective in correcting all grades of reflux. Best results are obtained when the paste is injected precisely into the floor of the submucosal ureter.