Endourological application of polydimethylsiloxane in the treatment of vesicoureteal reflux on children

Efrén Camacho-Muñoz; Daniel Aguirre-García; Acosta-Real Juan David; Fabiola Aguirre-Cervantes; Rodolfo Gutiérrez-Enríquez; Omar Sánchez-Álvarez; Óscar Aguirre-Jáuregui

2012, Number 2

Rev Med MD 2012; 3.4 (2)

Endourological application of polydimethylsiloxane in the treatment of vesicoureteal reflux on children

Camacho-Muñoz E, Aguirre-García D, Acosta-Real JD, Aguirre-Cervantes GF, Gutiérrez-Enríquez R, Sánchez-Álvarez O, Aguirre-Jáuregui O

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Language: Spanish
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ABSTRACT

Background: Between 3 5% of girls and 1 2% of boys suffer from a urinary infections before puberty. The vesicoureteal reflux (VUR) is a common urinary tract abnormality. Since 1980, the endoscopic handling for the VUR was an alternative to the prophylaxis with antibiotics for a prolonged time and the surgical intervention on children. We present the experience of our service in the endourological solution of pediatrics patients with VUR (uni or bilateral) through the endoscopical application of polydimethylsiloxane (PDMS).
Material and methods: It is a descriptive and observational study of patients with vesicoureteal grade II to V, from June of 2006 to August of 2007 in the unit of pediatric endourology of the Fray Antonio Alcalde Civil Hospital of Guadalajara.
Results: During the period of study were performed a total of 250 diverse endouscopical procedures in the unit of pediatric endourology. Of this total, 50 patients were identified with VUR grades II to V. 9 cases were excluded. From the rest, 30 (73%) were female patients and the remaining, male. The mean age was 5.3 years. Half of them presented only fever; in a quarter of the patients, it was associated with abdominal pain, lumbar pain, vomit and convulsive crises, and the other 25% presented urinary symptoms. On 32 patients (78%), was required only 1 application of PDMS; while on the rest, 2 were needed. In the follow up, was found that 67% (12 cases) of primary VUR were solved completely, 1 case presented migration of PDMS and the remaining diminished the grade of reflux. From the secondary VUR, 19 cases (55%) had a complete healing with the 1st injection, 15% (5) received a 2nd injection and on the rest, diminished the grade of reflux.
Conclusions: The endoscopical correction of the VUR on pediatrics is a safe, effective and less invasive alternative, with good results on primary and secondary refluxes, even on high grade. Diminishes and avoids the kidney damage associated to the prolonged use of antibiotics; besides can be performed in ambulatory care, representing an adequate alternative of handling.

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