[Symptomatic vesicoureteral reflux in kidney transplantation: results of endoscopic injections of teflon and predictive factors for success].
OBJECTIVE
Evaluation of the results of endoscopic Teflon injections for the treatment of symptomatic vesicoureteric reflux in renal transplant recipients and identification of prognostic factors.


METHODS
Between June 1997 and January 2002, out of a series of 408 renal transplant recipients, 15 patients (8 males, 7 females) with a mean age of 41.9 years were treated for symptomatic vesicoureteric reflux on the transplanted kidney by endoscopic Teflon injection. This treatment was indicated due to the presence of febrile or afebrile infections, possibly associated with deterioration of renal function. Reflux was demonstrated by retrograde cystography. The results of endoscopic treatment were evaluated by cystography at 3 months, and by clinical and laboratory examinations thereafter.


RESULTS
The mean interval between renal transplantation and endoscopic treatment was 64.2 +/- 64.7 months. With a mean follow-up of 25 +/- 16.7 months, we observed a 53.3% success rate (8 patients), 13.3% of patients (2 patients) were improved and 33.3% of procedures were considered to be failures (5 patients). A lower number of preoperative infections, reflux < or = grade III and the absence of impaired renal function are predictive factors for the success of endoscopic treatment. The only complication was one case of renal colic due to meatal stenosis at 3 months, which responded favourably to endoscopic treatment alone.


CONCLUSIONS
Endoscopic treatment of symptomatic vesicoureteric reflux on a transplanted kidney by Teflon injection is effective in two-thirds of cases. Due to the low morbidity of this minimally invasive procedure, this treatment should be proposed as first-line management for all cases of symptomatic vesicoureteric reflux on a transplanted kidney.
Mallet
Richard
R
Service d'Urologie, Andrologie et Transplantation Rénale, CHU Rangueil, 31403 Toulouse. xaviergame@hotmail.com
Game
Xavier
X
Mouzin
Marc
M
Sarramon
Jean-Pierre
JP
Vaessen
Christophe
C
Malavaud
Bernard
B
Rischmann
Pascal
P
D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D007267:Injections; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D011138:Polytetrafluoroethylene / Q000008:administration & dosage*; D011379:Prognosis; D012074:Remission Induction; D013997:Time Factors; D014718:Vesico-Ureteral Reflux / Q000209:etiology*
D011138:Polytetrafluoroethylene