ENDOSCOPIC TREATMENT OF REFLUX - EXPERIMENTAL-STUDY AND REVIEW OF TEFLON(R) AND COLLAGEN

Endoscopic correction of vesicoureteric reflux in children has been pe rformed in several hundred cases with the use of Teflon(R) or cross-li nked bovine collagen. The main criticism to this simple procedure is t he potential migration of Teflon particles and the local pathological reaction. An experimental study was performed in 20 rabbits injected w ith Teflon or collagen in the bladder submucosa. A pathological examin ation of the bladder, lymph nodes, liver, lungs and brain was performe d several months after the experiment to study the migration and the l ocal reaction. There is no local granulomatous reaction with collagen while a local granulomatous reaction is found in the site of injection of Teflon and in 1 locoregional lymph node. The colonization of colla gen by histiocytes increases with time. No distant granulomatous react ion was noted with both injections on histological examination. A mine ralogic technique was applied after homogenisation of the lungs and br ain to further investigate the distant migration problem. Rare particl es of Teflon were observed in the lungs but not in the brain. The path ological significance of these particles remains unclear, but calls fo r research for different injection materials.