PTU - Polskie Towarzystwo Urologiczne
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CODE: 17 - Endoscopic management of vesicoureteral reflux in children
Article published in Urologia Polska 2006/59/Suplement 1.


Bogusław Jakubowski, Janusz Ciechan, Ireneusz Ostrowski, Tadeusz Palec, Ludwik Kotliński
Oddział Urologii Szpitala Specjalistycznego w Puławach


Introduction. The vesicoureteral reflux is a common children disorder requiring surgical management in many cases. The aim of these procedures is to protect urinary system from infections and irreversible damage. The endoscopic method of vesicoureteral reflux treatment was first introduced in Poland in 1986.
Objectives. The aim of the study is to present our own experiences and results of vesicoureteral reflux endoscopic management with synthetic materials usage: teflon, collagen and dextranomer with hyaluronic acid
Materials and methods. The retrospective analysis covered 70 children between the age of 2 and 15 years (66 girls and 4 boys) with vesicoureteral reflux who underwent endoscopic treatment between 1991 and 2005. In the studied group there were 59 children with unilateral and 11 children with bilateral reflux. 21 children had II grade, 48 had III grade and 1 child had IV grade of vesicoureteral reflux. In all cases synthetic material was administered through urethra under bladder openings of the ureters. Teflon, collagen and dextranomer with hyaluronic acid were used in the procedures.
Results. The early effectiveness (1-3 days) of the treatment meant as reflux regression was found in 84% of cases for all materials, the late effectiveness (12-24 months) was 70% for teflon and collagen. The assessment of late effectiveness of the treatment with dextranomer with hyaluronic acid usage needs control studies.
Conclusions. Antireflux operation done through urethra is low invasive management of vesicoureteral reflux which could be successfully applied also in young children. It's a minimal invasive method of operational treatment. The transurethral operation is not an obstacle for future possible ureters operations.