Correction of vesicoureteral reflux in children by endoscopic collagen injection: a prospective study.

Abstract

The aim of our prospective study was to evaluate the long-term results of correction of vesicoureteral reflux in children by subureteral submucosal endoscopic collagen injection. Between May 1988 and June 1994, 197 refluxing ureters in 148 children (grade III or IV, international grading system) were treated by collagen injection. Injection was done using general anesthesia and repeated 1 or 2 times if reflux persisted on the 1-month followup radionuclide cystogram. Cystography was repeated at 6 months, 2 years and 4 years. After 1 month, 6 months, 2 years and 4 years grades III and IV reflux were cured in 93.9%, 91.7%, 85.3% and 81.8%, respectively, of 132 simple ureters. For the 27 duplex ureters success rates were 44.4%, 25.9%, 23.1% and 21.4%, respectively, after 1 month, 6 months, 2 years and 4 years. After failed injections neo-implantation was performed with no difficulty. Our results show that in simple ureters reflux, especially grade III, can be corrected by collagen injection. Results seem to be stable after 2 years of followup.