Endoscopic correction of vesicoureteric reflux in failed reimplanted ureters.

Abstract

Persistent vesicoureteral reflux (VUR) after reimplantation of ureters requiring reoperation has been reported in up to 7.5% of cases. We report our experience with endoscopic subureteric Teflon injection (STING) in the treatment of VUR after failure of reimplantation of ureters. Between 1985 and 1995, 31 children (18 male, 13 female) with persistent high-grade VUR after failure of reimplantation of ureters were referred to our hospital for endoscopic correction of VUR. The reflux was unilateral in 22 and bilateral in 9 (40 refluxing units). The ages at the time of STING ranged from 2 to 14 years. Ultrasound and voiding cystourethrography was performed in all patients at 3 months, 1 year and 3 years after STING procedure. Patients were followed-up for periods ranging from 1 to 11 years. VUR was successfully corrected in 27 ureters after a single injection. Seven ureters required two injections and 4 ureters three injections for the correction of reflux. Failure to correct reflux was noted in 2 ureters and these were corrected by reoperation. STING is a simple and effective day care procedure for the correction of VUR after failure of reimplantation of ureters.