Endoscopic Injection Techniques for Vesicoureteral Reflux

摘要: Vesicoureteral reflux (VUR) is the retrograde flow of urine from bladder to upper urinary tract and one most prevalent urologic diagnoses in children. Management options include observation with or without continuous antibiotic prophylaxis surgical correction via endoscopic, open, laparoscopic/robotic approaches. Surgical intervention may be necessary children persistent reflux, renal scarring, recurrent febrile infections cases parental choice. Endoscopic treatment VUR an outpatient procedure associated decreased morbidity compared ureteral reimplantation. The classic subureteral Teflon injection (STING) technique commonly described method now frequently referred as transurethral injection. It involves injecting a bulking material below orifice, providing tissue augmentation under refluxing orifice thereby increasing submucosal length ureter creating fixation point enhance valve mechanism. concept hydrodistention intraluminal (hydrodistention implantation HIT) has led improved success rates eliminating reflux. Modifications double HIT proximal distal injections that result coaptation both tunnel orifice.