[Transurethral teflon paste injection for vesicoureteral reflux in neurogenic bladder dysfunction].
We experienced transurethral teflon paste injection for 12 refluxing ureters of 7 patients with neurogenic bladder dysfunction. Preoperative assessment of cystometry showed hypoactive bladder function with normal bladder compliance in 4 patients, and low compliance bladder (< 10 ml/cmH2O) in 1. Voiding cystography revealed grade 1 reflux in 2 ureters, grade 2 in 3, grade 3 in 2, grade 4 in 2, and grade 5 in 2. One ureter did not show reflux. Zero point two to 1.6 ml of teflon paste was injected on each ureter under cystoscopic observation. These patients were followed for a mean of 25.1 months. Reflux disappeared immediately after the first operations in all patients, however recurrence was observed in 2 ureters, in which improvement of reflux (grade 5 to 2) was achieved in 1 ureter but no improvement (grade 2 to 2) in another. Pyelonephritis was not encountered in any patients after injection. No complication was observed through the follow up period. In conclusion, we advocate that endoscopic teflon paste injection is a useful alternative to ureteroneocystostomy in the treatment of reflux in patients with neurogenic bladder dysfunction.
Hashimoto
K
K
Department of Urology, Kinki University School of Medicine.
Kishima
Y
Y
Onishi
N
N
Esa
A
A
Sugiyama
T
T
Park
Y
Y
Kohri
K
K
Akiyama
T
T
Kurita
T
T
D000368:Aged; D002675:Child, Preschool; D003558:Cystoscopy; D005260:Female; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use*; D001750:Urinary Bladder, Neurogenic / Q000150:complications*; D014718:Vesico-Ureteral Reflux / Q000209:etiology / Q000628:therapy*
D011138:Polytetrafluoroethylene