The Early Experience and Technical Aspects of Endoscopic Subureteral Polydimethylsiloxane Injection for Vesicoureteral Reflux / 대한비뇨기과학회지
Korean Journal of Urology
;
: 154-159, 2006.
Article
in Korean
| WPRIM
| ID: wpr-24162
ABSTRACT
PURPOSE:
We reviewed the operative outcome and the cause of failure for performing subureteral injection of polydimethylsiloxane (PDS, Macroplastique(R), Uroplasty Inc. Geleen, The Netherlands), when it is used as a bulking agent for the endoscopic treatment of vesicoureteral reflux (VUR) patients. MATERIALS ANDMETHODS:
A total of 29 patients (a total of 37 ureters), with primary grades I to V VUR were treated with a single subureteral injection from 2001 to 2004; these patients were followed for an average of 21.5 months. Each patient underwent preoperative voiding cystourethrography, renal ultrasound, a dimercapto-succinic acid (DMSA) scan and urine culture. With the patient under general anesthesia, the PDS implant was injected transurethrally at the 6 o'clock position of the ureteral opening in the affected renal unit by a modified subureteral transurethral injection (STING) procedure. Renal ultrasound was done at 1 week and voiding cystourethrography was done at 3 months to rule out obstruction at the injection site and/or persistent reflux, respectively. Cure was defined as an absence of VUR on voiding cystourethrography at 3 months after injection. Statistical analyses were performed using the chi-square test.RESULTS:
The grade of reflux was I, II, III, IV and V in 6, 4, 12, 9 and 6 ureteral units respectively. After a single injection, the VUR was cured in 30 ureteral units (81.1%). There were 7 (18.9%) patients who received a second injection after a failed single injection. In these patients, the injected PDS volume was not changed on ultrasound. On the other hand, cystoscopy showed mound displacement in 4 patients, no volcano appearance but rather a broad elevation in 2 patient, and distal ureteral fistula and mound extrusion in 1 patient.CONCLUSIONS:
These results suggest that endoscopic subureteral polydimethylsiloxane injection is an effective treatment of VUR. The efficacy of subureteral injection can be improved by using the correct injection technique.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Ureter
/
Vesico-Ureteral Reflux
/
Ultrasonography
/
Cystoscopy
/
Fistula
/
Hand
/
Anesthesia, General
Type of study:
Diagnostic study
Limits:
Humans
Language:
Korean
Journal:
Korean Journal of Urology
Year:
2006
Type:
Article
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