title: Endoscopic treatment of vesicoureteral reflux with polydimethylsiloxane in adult women.
abstract: OBJECTIVE
  Subureteral injection of bulking agents to a refluxing ureteral orifice is an attractive alternative to open repair. We record our experience of the endoscopic subureteral injection of polydimethylsiloxane in women for vesicoureteral reflux (VUR).
  
  
  METHODS
  From January 1997 to December 2001, 30 women (mean age 34.9 years) with 43 refluxing ureters underwent endoscopic treatment. The grade of VUR was I, II, III, and IV in 10, 16, 13, and 4 ureters, respectively. The indication for the procedure was VUR with a history of pyelonephritis in women of childbearing age or in whom antibiotic prophylaxis had been unsuccessful. All women underwent voiding cystourethrogram at 3 months and then yearly after the procedures. Follow-up ranged from 12 to 60 months (mean 26.5 months).
  
  
  RESULTS
  Reflux was corrected in 34 ureters after a single injection; only 3 ureters needed a 2nd injection. The overall success rate was 86.0%: for grades I, II, III, and IV was 90.0%, 87.5%, 76.9%, and 100% respectively. The mean hospital stay was 1.31 days (range 1-8 days), and no remarkable surgical complications occurred. Most of the patients in whom VUR was cured or improved showed a reduction in laboratory-proven urinary infection rates.
  
  
  CONCLUSIONS
  The endoscopic subureteral injection of polydimethylsiloxane in women with vesicoureteral reflux is an effective therapy with no associated morbidity.
authors.affiliation: Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-dong, Songpa-gu, Seoul 138-736, Republic of Korea. MSChoo@amc.seoul.kr
authors.forename: Myung-Soo
authors.initials: MS
authors.lastname: Choo
authors.forename: Bumsik
authors.initials: B
authors.lastname: Hong
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Ji
authors.forename: Han
authors.initials: H
authors.lastname: Chung
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Choe
authors.forename: Won Hee
authors.initials: WH
authors.lastname: Park
authors.forename: Taehan
authors.initials: T
authors.lastname: Park
authors.forename: Kyu-Sung
authors.initials: KS
authors.lastname: Lee
mesh_terms: D000328:Adult; D004129:Dimethylpolysiloxanes / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008875:Middle Aged; D012828:Silicones / Q000008:administration & dosage*; D014513:Ureter; D018666:Ureteroscopy; D014718:Vesico-Ureteral Reflux / Q000628:therapy*
chemical_list: D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon