POLYTETRAFLUOROETHYLENE GIANT GRANULOMA AND ADENOPATHY - LONG-TERM COMPLICATIONS FOLLOWING SUBURETERAL POLYTETRAFLUOROETHYLENE INJECTION FOR THE TREATMENT OF VESICOURETERAL REFLUX IN CHILDREN

Purpose: The use of polytetrafluoroethylene as bulking agent for the e ndoscopic treatment of vesicoureteral reflux in children has raised ma ny concerns about the implant histocompatibility and the risk of migra tion of polytetrafluoroethylene particles. We report on 3 cases of lon g-term complications following subureteral polytetrafluoroethylene inj ection (STING) and an extensive review of the literature is presented. Materials and Methods: Between January 1993 and December 1995, 3 chil dren (2 males, 1 female; 4, 7 and 6 years old), previously submitted t o STING, underwent open surgery for recurrent vesicoureteral reflux. R esults: In 1 case a hard nodular mass, strictly adherent to the ureter al wall, was a foreign body giant granuloma. All patients demonstrated a heavy multinucleated foreign body reaction around polytetrafluoroet hylene particles in the pelvic nodes. Conclusions: Many experimental s tudies and some clinical observations have demonstrated that polytetra fluoroethylene particles elicit a foreign body granulomatous reaction and have the tendency to migrate. Until the long-term effects of their presence are well known, STING should be carefully evaluated in child ren and young patients.