The long-term outcome of the endoscopic subureteric implantation of polydimethylsiloxane for treating vesico-ureteric reflux in children: a retrospective analysis of the first 195 consecutive patients in two European centres.

ABSTRACT

OBJECTIVE: To determine the long-term efficacy of endoscopically implanting polydimethylsiloxane (PDS, Macroplastique, Uroplasty BV, Geleen, the Netherlands) for treating vesico-ureteric reflux (VUR) in children. PATIENTS AND METHODS: We retrospectively reviewed the records of 195 children treated with PDS over the past 10 years in two European centres (Netherlands and UK) and conducted follow-up investigations where deemed necessary. In the Dutch centre patients were treated according to a prospective approved study protocol. RESULTS: Of the 195 treated children, 155 had a successful outcome; in all, 311 refluxing renal units were treated, with an overall success rate of 82.3% in a mixed group of patients with unilateral or bilateral VUR and duplex systems. CONCLUSION: The long-term data from these two independent centres confirms the viability of PDS and the technique for treating VUR in children. We conclude that the material is safe and effective and can be used in VUR grades II-V. Treating patients with grade I VUR is recommended in those cases where there is no spontaneous resolution and 'breakthrough' infections.