Complicaciones del tratamiento endoscópico del reflujo vesicoureteral en la infancia

Abstract

IntroductionNowadays, around 1% of children suffer from vesicoureteral reflux (VUR), which represents a risk factor for long-term kidney damage. In the last decade, development in this field has shown that subureteric endoscopic injection of bulking agents for childhood VUR is an acceptable alternative unlike long-term antibiotic prophylaxis and open surgery. ObjectiveTo establish the complications of childhood VUR endoscopic treatment. Material y métodosA retrospective analysis was carried out for every patient treated endoscopically in our department from January 1999 to September 2003, with a total amount of 516 implants of submucous bulking agents. All patients were assessed with an ultrasound as a first diagnostic technique so as to establish the complications associated with it, especially ureteral obstruction and injected agent migration. ResultsOut of 516 cases, Macroplastique® was used in 455, Deflux® in 44 and Polytef® in 17. 10 patients (1.9%) (5 girls/ 5 boys), with ages ranging from 15 months to 11,4 years, presented some kind of complications (Macroplastique® was used in 8cases and Deflux® in 2). Among them, 5 were remarkable due to an ureterohydronefrosis, 2 of which needed a nephrostomy. 3 patients presented an implant migration, 1 epididymitis and 1 bladder edema. ConclusionsEndoscopic bulking agent injection has become a safe alternative to open surgery in childhood VUR management.