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Comparison of results in endoscopic management of the vesico-ureteral reflux employing various materials (1996-2004)
Article published in Urologia Polska 2007/60/1.


Wiesław Urbanowicz, Michał Wolnicki, Janusz Sulisławski, Radosław Mycek
Klinika Urologii Dziecięcej Katedry Chirurgii Pediatrycznej Collegium Medicum Uniwersytetu Jagiellońskiego


urinary tract, vesico-ureteral reflux, endoscopic treatment, collagen, blood, dextranomer, children


Introduction. Primary vesico-ureteric reflux (VUR) is a common congenital uropathy in children. Medical treatment is not always successful, while surgical treatment imposes a great burden of the patient. The endoscopic injection is an alternative treatment option.
The aim of the study. The aim of this study is a comparison and analysis of the results of endoscopic treatment of vesico-ureteric reflux using various materials.
Material and methods. In the report period, in the Pediatric Urology Department, 207 children (257 ureters) were managed endoscopically. The technique of endoscopic injection was identical in all the patients, but the employed materials, both natural and artificial, were different. The results were compared in groups injected with various preparations, as well in groups with various degrees of reflux.
Results. The improvement rate was 55% after blood injection, 72.3% after collagen injection and 80% after dextranomer injection. (Table I)
Conclusions. 1. The effectiveness of endoscopic treatment of vesico-ureteric reflux is high in the majority of patients. 2. The most effective material in the treatment of VUR is dextranomer. 3. The complication rate is low and not related to the type of material used. 4. The endoscopic implantation of the ureteral orifice in the treatment of VUR is a minimally invasive procedure and it significantly affects the success rate.


  1. Błaszczyński M, Jankowski A, Martyński M: Review of surgical treatment results for vesicoureteral reflux in children using the Politano-Leadbetter technique. Wiad Lek suppl 1998, 51, 40.
  2. Greenfield SP, Manyan N, Wan J: Resolution rates of low grade vesicoureteral reflux statiefied by patient age at presentation. J. Urol 1997, 157: 1410
  3. Leissner J, Allhoff EP, Wolff W et al: The pelvic plexus and antireflux surgery: topographical findings and clinical consequences. J Urol, 2003, 165, 1652-1655.
  4. Puri P, O`Donell B: Endoscopic correction of grades IV and V primary vesocouretery reflux six to 30 month follow up in 42 ureters. J Ped Surg 1987, 22, 1087.
  5. Urbanowicz W, Górniak M, Wolnicki M: Endoskopowe leczenie odpływów pęcherzowo-moczowodowych. Chir Dziec 2000, 1, 33, 36.
  6. Puri P, Ninan G, Surana R: Subureteric teflon injection (STING). Results of European survey. Eur Urol 1995, 27, 71.
  7. Aygun C, Ozer A, Dirim MI et al: Renal transplantation experience following endoscopic treatment of vesicoureteral reflux. Elsevier, Transplantation proceedings. 2004, 36, 68-70
  8. Koenig DM, Diamond DA, Rabinowitz R: Contralateral reflux after unilateral ureteral reimplantation. J Urol 1996, 156, 196-197.
  9. Aaronson IA, Rames RA, Greene WB et al: Endoscopic treatment of reflux: migration of Teflon to the lungs and brain. Eur Urol 1993, 23, 394-399.
  10. Górski K, Fryczkowski M: Skuteczność endoskopowego leczenia teflonem pierwotnego odpływu pęcherzowo-moczowodowego u dzieci. Urol Pol 2002, 55, 3.
  11. Frey P, Lutz N, Jenny P, Herzog B: Endoscopic subureteral collagen injection for the treatment of vesicoureteral reflux ion infants and children. J Urol 1995, 154, 804.
  12. Jakubowski B, Ciechan J, Ostrowski I i in: Endoskopowe leczenie dzieci z odpływami pęcherzowo-moczowodowymi. Urol Pol 2006, supl 1, 33.
  13. Lackren G: Long term follow up of children treated with dextranomer/hyaluronic acid copolymer for vesicoureteral reflux. J Urol 2001, 166, 1887-1992.
  14. Bartoli F, Niglio F, Gentile O et al: Endoscopic treatment with polydimethylsiloxane in children with dilating vesico-ureteric reflux. BJU Int. 2006, 97, 805-808.
  15. Capozza N, Caione M, De Gennaro M et al: Endoscopic treatment of vesico-ureteric reflux and urinary incontinence: technical problems in the paediatric patient. Br J Urol 1995, 75, 538.


Wiesław Urbanowicz
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