Puri P, O'Donnell B
Br Med J (Clin Res Ed). 1984 Jul 7;289(6436):5-7. doi: 10.1136/bmj.289.6436.5.
Vesicoureteric reflux was produced in eight piglets by opening their bladders and slitting the anterior intravesical wall of the ureter. Cystography confirmed the presence of bilateral reflux in six piglets and unilateral reflux in two. Six to eight weeks later the bladder was again opened and Teflon paste injected in the space behind the intravesical ureter, thereby creating a support for the submucosal ureter. Cystography four to six weeks after injection of Teflon paste showed absence of reflux in all animals. Intravenous pyelography showed obstruction at the vesicoureteric junction in only one of the 14 treated ureters and this was later confirmed at necropsy. Animals were followed up from one to six months and then were killed. Gross examination of the vesicoureteric region showed a well circumscribed subureteric Teflon mass of firm consistency, retaining its shape and position at the site of the injection. Histological examination showed encapsulation of the implant by a thin layer of fibrous tissue and a foreign body granulomatous reaction with histiocytes and giant cells within the implant. Hence it is technically feasible to correct experimentally produced vesicoureteric reflux in the piglet by intravesical injection of Teflon paste--a relatively inert material. It may now be possible to treat vesicoureteric reflux in man by endoscopic injection of Teflon behind the intravesical ureter.
通过打开八只仔猪的膀胱并切开输尿管膀胱内前壁，制造膀胱输尿管反流。膀胱造影证实六只仔猪存在双侧反流，两只存在单侧反流。六至八周后，再次打开膀胱，将聚四氟乙烯糊剂注入膀胱内输尿管后方的间隙，从而为黏膜下输尿管提供支撑。注射聚四氟乙烯糊剂四至六周后的膀胱造影显示，所有动物均无反流。静脉肾盂造影显示，14条接受治疗的输尿管中只有一条在膀胱输尿管连接处存在梗阻，这一点在尸检时得到了证实。对动物进行了1至6个月的随访，然后将其处死。膀胱输尿管区域的大体检查显示，输尿管下有一个边界清晰的聚四氟乙烯肿块，质地坚实，在注射部位保持其形状和位置。组织学检查显示，植入物被一层薄纤维组织包裹，并在植入物内出现了由组织细胞和巨细胞引起的异物肉芽肿反应。因此，通过膀胱内注射聚四氟乙烯糊剂（一种相对惰性的材料）在实验中纠正仔猪的膀胱输尿管反流在技术上是可行的。现在有可能通过内镜在膀胱内输尿管后方注射聚四氟乙烯来治疗人类的膀胱输尿管反流。
