[Endoscopic treatment of vesicorenal reflux in children: short- and long-term results of polytetrafluoroethylene (Teflon) injections].

OBJECTIVE

To retrospectively evaluate the short-term and long-term efficacy and safety of endoscopic treatment of vesicorenal reflux in children by polytetrafluoroethylene injection, based on the largest series published in the literature.

MATERIAL AND METHODS

Six hundred and fifty ureters in 402 children were by subureteric injection of polytetrafluoroethylene from 1986 to 1993. The short-term results were evaluated one month and one year after treatment by physical examination, urine culture, bladder and renal ultrasonography and retrograde cystography. The long-term results were evaluated with a mean follow-up of 116 months by physical examination, renal ultrasonography, questionnaire for the patient's family and urine culture.

RESULTS

86.6% refluxing ureters in 82.1% of children were cured after endoscopic treatment. No serious short-term complications were observed. In the long-term, 97% of children never presented an episode of pyelonephritis. Ultrasonographic assessment did not reveal any dilatation of the upper urinary tract, no any suspicious lesions of the bladder wall. Continuing reflux nephropathy due to chronic pyelonephritis was observed in 4.4% of treated kidneys, despite satisfactory correction of reflux. No local complications related to the biomaterial and no signs suggestive of distant diseases induce by migration of Teflon particles were observed. No malignant degeneration was reported.

CONCLUSIONS

Review of this series demonstrates the short-term efficacy and long-term maintenance of the good results of endoscopic treatment of reflux. No local complication and no complications due to migration of Teflon were observed in this series. This procedure avoided the need for conventional ureteric reimplantation in 92% of treated children.