Endoscopic Treatment of Vesicoureteric Reflux in Transplanted Kidneys

Abstract

Twenty-one patients underwent endoscopic subureteric injection of Polytef paste for the correction of secondary vesicoureteric reflux (VUR) in transplanted kidneys. Ureteroneocystotomy was performed in renal transplants using an extravesical technique in 19 patients and the Leadbetter-Politano technique in 2 cases. Success was achieved in only 6 patients, including the 2 ureters reimplanted according to the Leadbetter-Politano technique. No significant complication relating to the technique was observed. Despite the low success rate (30%), endoscopic treatment of VUR in transplanted kidneys is justified as a first attempt in view of the morbidity of VUR and the difficulties of repeated surgical reimplantation in this population.

Endoscopic Subureteral Polydimethylsiloxane Injection and Prevention of Recurrent Acute Graft Pyelonephritis

“…Therefore, PDS treatment is recommended as preferable to surgical reimplantation [15,16,17]. However, there has only been one report of endoscopic PDS treatment in renal transplant recipients, with a 30% success rate [21]. In our study, the overall success rate of endoscopic treatment using PDS was 63.2%, which is similar to the success rate in pediatric patients with VUR.…”

Endoscopic treatment of symptomatic refluxing renal transplant ureteroneocystostomies in children

“…Cloix et al. (8) found that in their 21 patients with secondary VUR after transplant, only 30% of patients had resolution of their reflux with subureteric injection of Polytef paste. Similarly, Mallet et al.…”

Transurethral injection therapy with carbon‐coated beads (Durasphere®) for treatment of recurrent pyelonephritis in kidney transplant patients with vesico‐ureteral reflux to the allograft

“…and Mallet et al. (24, 25). We estimated the cost of an open procedure to be U$9263.00 compared to U$1947.00 per treatment for the endoscopic procedure.…”

“…Although endoscopic treatment has a lower success rate compared to open conventional surgery, it has the advantage of being an outpatient procedure that is minimally invasive with a low morbidity and a lower overall cost (23). This is particularly true in renal transplant patients, as has been demonstrated by Cloix et al and Mallet et al (24,25). We estimated the cost of an open procedure to be U$9263.00 compared to U$1947.00 per treatment for the endoscopic procedure.…”