title: [Symptomatic vesicoureteral reflux in kidney transplantation: results of endoscopic injections of teflon and predictive factors for success].
abstract: 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.
authors.affiliation: Service d'Urologie, Andrologie et Transplantation Rénale, CHU Rangueil, 31403 Toulouse. xaviergame@hotmail.com
authors.forename: Richard
authors.initials: R
authors.lastname: Mallet
authors.forename: Xavier
authors.initials: X
authors.lastname: Game
authors.forename: Marc
authors.initials: M
authors.lastname: Mouzin
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Sarramon
authors.forename: Christophe
authors.initials: C
authors.lastname: Vaessen
authors.forename: Bernard
authors.initials: B
authors.lastname: Malavaud
authors.forename: Pascal
authors.initials: P
authors.lastname: Rischmann
mesh_terms: 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*
chemical_list: D011138:Polytetrafluoroethylene