The clinical utility and safety of the endoscopic treatment of vesicoureteral reflux in patients with duplex ureters

Polydimethylsiloxane (macroplastique®) injection for vesicoureteral reflux in duplex ureters: A comparison with single renal systems

“…Parents are forewarned about the risk of transitory partial ureteral obstruction, because it is our policy to overcorrect VUR, especially in severe cases, and wait for rapid re-absorption of the povidone component (this process usually takes a few weeks and decreases the implant volume by at least 20%). Our results are in accordance with a recent review that showed no difference in success rate between SS and DS with the use of Deflux, or other bulking agent [10].…”

“…Endoscopic injection of bulking agents is now widely employed as an effective alternative to surgery, even in severe VUR [7e9]. Recent reports have suggested that endoscopic injection of bulking agents may be effective in the treatment of mild-tomoderate VUR in DS [10], but severe VUR in patients with a DS is often treated by open surgery [11e13]. Polydimethylsiloxane (PDS) (Macroplastique Ò , MPQ, Uroplasty BV, Geleeen, The Netherlands) is a non-biodegradable substance with a low risk of migration, because most particles are 100e200 mm in diameter and macrophages (the main cells responsible for foreign body migration) can only scavenge particles less than 80 mm in diameter.…”

Endoscopic injection therapy

“…However, several studies evaluating potential predictors of success with injection therapy reported that ureteral duplication was not associated with treatment failure [3749]. More recent studies have reported better success rates (68.4%–73%) after a single injection [505152], with the possibility of additional injections if needed.…”

Is a third endoscopic treatment for vesicoureteral reflux indicated if previous attempts have failed?

“…These results indicate that the presence of these factors is not a contraindication for a further endoscopic injection [15,16].…”