Korean J Urol.  2007 Jan;48(1):82-86. 10.4111/kju.2007.48.1.82.

Experience of Subureteral Polydimethylsiloxane Injection Treatment in Children with Vesicoureteral Reflux

• Sung HH
• Park HJ
• Park KH

• KMID: 1915027
• DOI: http://doi.org/10.4111/kju.2007.48.1.82

Abstract

PURPOSE: Our data was retrospectively reviewed to assess the efficacy, safety and costs of endoscopic subureteral polydimethylsiloxane (PDS, Macroplastique(R)) injection treatment for children with vesicoureteral reflux (VUR).
MATERIALS AND METHODS
Between December 1997 and May 2006, a total of 24 (29 renal units) VUR patients, whose parents showed reluctance toward open surgery, underwent subureteral PDS injection treatment. All of the patients were postoperatively assessed by voiding cystourethrography (VCUG) and ultrasound to evaluate any complications and reflux. The medical costs of the injection treatment were compared with those of open surgery for VUR over the same period.
RESULTS
The mean follow-up was 15 months (range 2-72). Of the 29 renal units treated, 24 (82.8%) were cured. Hydronephrosis, which postoperatively developed in three renal units, was spontaneously improved or resolved after minimal endourological procedures. Temporary gross hematuria and voiding difficulty occurred in one patient each, but were also improved. The total medical costs of the injection treatment were cheaper than those of open surgery (p<0.05).
CONCLUSIONS
An endoscopic subureteral PDS injection is an effective and safe procedure; in addition, compared to open surgery, is an economic treatment for children with VUR.

Keyword

Vesicoureteral reflux; Injection; Treatment; Polydimethylsiloxane; Child

MeSH Terms

Child*
Follow-Up Studies
Hematuria
Humans
Hydronephrosis
Parents
Retrospective Studies
Ultrasonography
Vesico-Ureteral Reflux*

Figure

• 

  Fig. 1 Outcomes of subureteral PDS injection treatment for VUR. *: one of the bilateral refluxing ureters in a bilateral duplicated system improved from GIII to GI, but the patient was lost to follow-up, †: two patients with persistent VUR GIII, with newly developed contralateral GII VUR, were finally lost to follow-up, ‡: one patient persisted after a 2nd injection, and was cured after open surgery. PDS: polydimethylsiloxane, VUR: vesicoureteral reflux.

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