Endoscopic treatment of primary vesicoureteric reflux in infants by subureteric injection of polytetrafluoroethylene. A 9-year follow-up

Abstract

Fifty-two infants (75 ureters) with primary high-grade vesicoureteric reflux (VUR) treated endoscopically by subureteric injection of Polytef paste (STING) were followed up for 1-9 years. There were 30 boys and 22 girls and their ages ranged from 2 to 12 months. Forty-five percent of ureters had grade III VUR, 40% had grade IV and 15% had grade V VUR. Reflux ceased in 49 (65%) ureters after a single injection. Twenty-four percent of ureters in this series required more than one injection of Polytef paste to correct VUR. STING failed to correct VUR in 3 (4%) ureters. Eighty percent of the 49 ureters corrected after a single injection of Polytef required < 0.2 ml of paste per ureter to correct reflux. Ninety-three percent of ureters continue to show absence of VUR 1-9 years after endoscopic correction. Three of the 5 recurrences were only of grade I or grade II severity and required no treatment. No untoward effects were seen in these children with the use of Teflon as an injectable biomaterial. This day care procedure is simple, safe and effective in correcting high grades of reflux in infants.