ENDOSCOPIC TREATMENT OF VESICOURETERAL REFLUX IN NEUROGENIC BLADDER -8 YEARS EXPERIENCE

During an 8-year period, 51 children with neurogenic bladder had endos copic injection of Teflon (STING) for the management of 69 refluxing u reters. There were 21 boys and 30 girls (age range, 10 month to 16 yea rs). Vesico-ureteral reflux (VUR) had been present for a mean of 4.1 y ears, end severity distribution was as follows: grade I, 1 ureter; gra de II, 5 ureters, grade III, 9 ureters; grade IV, 39 ureters; and grad e V, 15 ureters. The follow-up period ranged from a months to 8 years (mean, 4 years). Reflux ceased in 57 ureters (82%); in four ureters th e VUR recurred (9 months to 6 years later). Bilateral vesico-ureteric junction (VUJ) obstruction occurred in one patient, which required sur gical correction 3 years after STING. These data suggest that far diff icult cases of VUR in neurogenic bladders, STING is a safe and effecti ve option and should be the initial treatment of choice. However, beca use of the possibility of late recurrence of VUR or obstruction at the VUJ, long-term follow-up is required. Copyright (C) 1996 by W.B. Saun ders Company