Between May 1984 and April 1990, 37 children with vesico-ureteric reflux(VUR) in 43 duplex systems were treated by endoscopic subureteric Teflon injection (STING). There were 32 girls and 5 boys; the duplex systems were complete in 27 refluxing units and incomplete in 16 refluxing units. All patients had high-grade reflux. In incomplete duplicated systems, YUR was corrected in 14 (87.5%) after a single injection of polytef paste and 2 patients required 2 injections to correct VUR. Of the 27 refluxing units with complete ureteral duplication, reflux was corrected in 16 (59%) units after a single injection of polytef paste, and 3(11 %) units showed improvement of VUR to grade I or II after 1 injection; no further treatment was given. 7 units with complete ureteral duplication required 2-4 injections for correction of VUR. STING failed to correct VUR in 1 duplex system which required a re-implantation. In 93% of refluxing units where VUR was corrected by a single injection, the quantity of polytef paste used was less than 0.3 ml. 36 (97%) of patients were discharged home on the day of the procedure. All patients were followed up for 2-8 years. Of the corrected ureters, there were no recurrences in the incomplete duplicated ureters. 3 of the completely duplicated ureters showed recurrence of reflux at follow-up micturating cystography. One had grade I reflux and needed no treatment and 2 had grade III reflux and required re-injection. There was no evidence of delayed vesico-ureteric obstruction or other complications even in ureters which had multiple injections. Endoscopic correction of VUR using polytef paste was found to be a simple, well-tolerated day care procedure, effective in correcting all grades of VUR in duplex ureters.

Keywords:
Subureteric Teflon injection, Polytetrafluoro-ethylene, Vesico-ureteric reflux, Duplex systems
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1993
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