Endoscopic treatment of vesicoureteral reflux with polydimethylsiloxane in adult women.
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.
Choo
Myung-Soo
MS
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
Hong
Bumsik
B
Ji
Young Hwan
YH
Chung
Han
H
Choe
Jin Ho
JH
Park
Won Hee
WH
Park
Taehan
T
Lee
Kyu-Sung
KS
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*
D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon