Subureteric Polytef injection in the management of vesico-ureteric reflux in children.

Subureteric Polytef injection is one of the alternatives now available for the management of vesico-ureteric reflux in children. The results of the treatment by one surgeon, over a 2 year period, were studied prospectively in 47 children (60 refluxing units). Following a single injection, reflux was abolished in 49 (82%) ureters and of the 11 failures, 10 ureters showed a reduction of the grade of reflux while one remained unchanged. A repeat injection was performed in nine of these ureters with success in five, persistence in two, and two children are awaiting a follow-up cystogram. The conservative success, with the addition of a second injection, was 90% (54/60). Of the four with unresolved reflux, two have low grade reflux and are free of infection, and two have had a ureteric reimplant, one of which was after a single injection, at the request of the parents. There were no instances of ureteric obstruction. These results show a viable, minimally invasive alternative to open ureteric reimplantation in the management of vesico-ureteric reflux in children.