Long-term results and curative mechanisms of vesicoureteral reflux by endoscopic injection of blood.
We describe our new endoscopic procedure for correction of ureterovesical reflux by endoscopic injection of the patient's own heparinized blood behind the ureteral orifice. Before drawing out the needle, small amounts of thrombin and protamine were injected to prevent the injected blood from leaking. Of the 16 ureters treated (13 patients) with international grade I-III reflux, 9 showed complete absence of reflux. The technique is advantageous because it is technically simple and injection can be repeated until the reflux had disappeared. Furthermore, no complications such as distant migration of injected material or escape from the bladder mucosa have been observed. However, the treatment is not consistently successful in cases of high-grade reflux. After the operation, mucosal swelling of ureteral orifice and narrowing of the intramuscular ureter were observed by ultrasonography. The mean pressure of the intramuscular ureter increased 10 cm H2O after the operation. These consequences of the operation may prevent vesicoureteral reflux.
Kohri
K
K
Department of Urology, Kinki University School of Medicine, Osaka, Japan.
Umekawa
T
T
Esa
A
A
Kaneko
S
S
Akiyama
T
T
Kurita
T
T
D001769:Blood; D003558:Cystoscopy; D006801:Humans; D011312:Pressure; D014513:Ureter / Q000503:physiopathology; D014718:Vesico-Ureteral Reflux / Q000503:physiopathology / Q000628:therapy*