Subureteric lipoinjection for vesicoureteral reflux in renal transplant candidates.
OBJECTIVE
Vesicoureteral reflux is a risk factor predisposing to infection after renal transplantation. Endoscopic correction of vesicoureteral reflux, a minimally invasive therapy, has been increasingly used with encouraging results. Although recent reports have described the successful use of Teflon paste in the endoscopic treatment of reflux, the choice of the material to be used is controversial. There is a need for finding an ideal substance for endoscopic injection for a simple and safe treatment of reflux.


METHODS
Based on the good results of autologous lipoinjection in other situations, we performed lipoinjection for vesicoureteral reflux in 12 renal transplant candidates. There were 10 female and 2 male patients with grade III reflux or higher, accounting for 17 ureters treated by endoscopic lipoinjection. Voiding cystourethrography was performed in the operating room immediately after the procedure and again three months later.


RESULTS
In 2 patients (16.2%) there was reduction of the grade of reflux, including the unique ureter that stopped refluxing. In the remaining 10 patients (83.3%) there was no change in the grade of reflux.


CONCLUSIONS
These results suggest that although simple and attractive, lipoinjection alone is not a good alternative for endoscopic correction of vesicoureteral reflux.
Palma
P C
PC
Division of Urology, University of Campinas Medical Center, Unicamp, Sao Paulo, Brazil.
Ferreira
U
U
Ikari
O
O
Rodrigues Netto
N
N
D000273:Adipose Tissue / Q000637:transplantation*; D000328:Adult; D005260:Female; D006801:Humans; D007267:Injections; D016030:Kidney Transplantation; D015187:Lipectomy; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors; D014182:Transplantation, Autologous; D014513:Ureter; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology / Q000601:surgery*