Palma P C, Ferreira U, Ikari O, Rodrigues Netto N
Division of Urology, University of Campinas Medical Center, Unicamp, Sao Paulo, Brazil.
Urology. 1994 Feb;43(2):174-7. doi: 10.1016/0090-4295(94)90039-6.
Vesicoureteral reflux is a risk factor predisposing to infection after renal transplantation. Endoscopic correction of vesicoureteral reflux, a minimally invasive therapy, has been increasingly used with encouraging results. Although recent reports have described the successful use of Teflon paste in the endoscopic treatment of reflux, the choice of the material to be used is controversial. There is a need for finding an ideal substance for endoscopic injection for a simple and safe treatment of reflux.
Based on the good results of autologous lipoinjection in other situations, we performed lipoinjection for vesicoureteral reflux in 12 renal transplant candidates. There were 10 female and 2 male patients with grade III reflux or higher, accounting for 17 ureters treated by endoscopic lipoinjection. Voiding cystourethrography was performed in the operating room immediately after the procedure and again three months later.
In 2 patients (16.2%) there was reduction of the grade of reflux, including the unique ureter that stopped refluxing. In the remaining 10 patients (83.3%) there was no change in the grade of reflux.
These results suggest that although simple and attractive, lipoinjection alone is not a good alternative for endoscopic correction of vesicoureteral reflux.
膀胱输尿管反流是肾移植后易发生感染的一个危险因素。膀胱输尿管反流的内镜矫正作为一种微创治疗方法，已越来越多地被使用且效果令人鼓舞。尽管最近的报告描述了聚四氟乙烯糊剂在内镜治疗反流中的成功应用，但所使用材料的选择仍存在争议。需要找到一种理想的物质用于内镜注射，以便简单安全地治疗反流。
基于自体脂肪注射在其他情况下取得的良好效果，我们对12例肾移植候选者的膀胱输尿管反流进行了脂肪注射。有10例女性和2例男性患者存在III级或更高等级的反流，共17条输尿管接受了内镜脂肪注射治疗。术后立即在手术室进行排尿性膀胱尿道造影，并在三个月后再次进行。
2例患者（16.2%）反流等级降低，其中1条输尿管停止了反流。其余10例患者（83.3%）反流等级无变化。
这些结果表明，尽管自体脂肪注射简单且有吸引力，但单独使用它并非内镜矫正膀胱输尿管反流的良好选择。
