Endoscopic treatment of vesicorenal reflux in children: long-term and short-term results of polytetrafluoroethylene (Teflon) injections.

Objective: To retrospectively evaluate the short-term and longterm efficacy and safety of endoscopic treatment of vesicorenal reflux in children by po lytetrafluoroethylene injection, based on the largest series published in t he literature. Material and Methods: Six hundred and fifty ureters in 402 children were by subureteric injection of polytetrafluoroethylene from 1986 to 1993. The sh ort-term results were evaluated one month and one year after treatment by p hysical examination, urine culture, bladder and renal ultrasonography and r etrograde cystography. The long-term results were evaluated with a mean fol low-up of 116 months by physical examination, renal ultrasonography, questi onnaire for the patient's family and urine culture. Results: 86.6% refluxing ureters in 82.1% of children were cured after endo scopic treatment. No serious short-term complications were observed. In the long-term, 97% of children never presented an episode of pyelonephritis. U ltrasonographic assessment did not reveal any dilatation of the upper urina ry tract, no any suspicious lesions of the bladder wall. Continuing reflux nephropathy due to chronic pyelonephritis was observed in 4.4% of treated k idneys, despite satisfactory correction of reflux. No local complications r elated to the biomaterial and no signs suggestive of distant diseases induc e by migration of Teflon particles were observed. No malignant degeneration was reported. Conclusions: Review of this series demonstrates the short-term efficacy and long-term maintenance of the good results of endoscopic treatment of reflu x. No local complication and no complications due to migration of Teflon we re observed in this sen. es. This procedure avoided the need for convention al ureteric reimplantation in 92% of treated children.