Document Detail


Outcome of endoscopic treatment for vesicoureteral reflux in children using polydimethylsiloxane.
MedLine Citation:
PMID:  12394755     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: We reviewed the outcome of subureteral injection of polydimethylsiloxane as a bulking agent for endoscopic treatment for vesicoureteral reflux in patients younger than 12 years. MATERIALS AND METHODS: A total of 40 children (59 ureters) with primary grades II to IV vesicoureteral reflux were treated with a single subureteral injection from 1997 to 2001 and followed an average of 26 months (range 4 to 45). Results in 38 patients (55 ureteral units) were available for review. Each child underwent preoperative voiding cystourethrography, renal ultrasound, dimercapto-succinic acid scan and urine culture. Treatment was done on an outpatient basis. With the patient general anesthesia polydimethylsiloxane implant was injected transurethrally below the ureteral opening of the affected renal unit. Renal ultrasound at 1 week and voiding cystourethrography at 2 months were done to rule out obstruction at the injection site and/or persistent reflux, respectively. Cure was defined as absent vesicoureteral reflux on voiding cystourethrography 2 months after injection. RESULTS: After a single injection polydimethylsiloxane cured vesicoureteral reflux in 45 ureteral units (81.8%), while in 5 (9.1%) the condition was improved. The remaining 5 ureteral units (9.1%) showed no change in reflux grade. In 1 patient (1.9%) with unilateral grade IV vesicoureteral reflux contralateral reflux developed. None of the cured patients had recurrent reflux during followup. In 1 patient ureteral obstruction was successfully treated with ureteral reimplantation. CONCLUSIONS: Endoscopic subureteral injection of polydimethylsiloxane implant in children with primary grades II to IV vesicoureteral reflux appears to be an effective, safe and minimally invasive technique.
Authors:
Adel A Al-Hunayan; Elijah O Kehinde; Mamdouh A Elsalam; Rola S Al-Mukhtar
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  168     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-23     Completed Date:  2002-11-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2181-3     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatric Surgery, Bin Sina Hospital, and Faculty of Medicine, Kuwait University, Safat, Kuwait.
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MeSH Terms
Descriptor/Qualifier:
Child
Child, Preschool
Dimethylpolysiloxanes / administration & dosage*
Female
Follow-Up Studies
Humans
Injections
Male
Postoperative Complications / radiography
Prostheses and Implants*
Silicones / administration & dosage*
Treatment Outcome
Ureteroscopy*
Urography
Vesico-Ureteral Reflux / radiography,  surgery*
Chemical
Reg. No./Substance:
0/Dimethylpolysiloxanes; 0/Silicones; 63148-62-9/baysilon
Comments/Corrections
Comment In:
J Urol. 2003 Jun;169(6):2303; author reply 2303   [PMID:  12771782 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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