Endoscopic Correction of Vesicoureteral Reflux: Our Experience with 115 Ureters

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Abstract
Endoscopic subureteral injection of polytetrafluoroethylene was performed in 115 ureters to correct vesicoureteral reflux. We treated primary reflux in 84 single ureters, 16 duplex ureters and 4 megaureters (grade V), and secondary reflux in 11 ureters associated with neurogenic bladder, uncapped ureteroceles and failed ureteroneocystostomy. Followup evaluation consisted of a voiding cystourethrogram, which was done in the operating room immediately after the endoscopic procedure, ultrasound 1 month postoperatively, and a diethylenetriaminepentaacetic acid renal isotope scan and repeat voiding cystourethrogram 6 months after injection. Grades II to IV primary reflux involving single as well as duplex ureters resolved in 94% and 82%, respectively, of the cases after 1 injection and in 98% and 93% of the cases after 2 or more injections. The severely and chronically dilated ureters did not respond to the treatment.