Traitement endoscopique du reflux vésicorénal chez l'enfant.

: Based upon a 7 years personal experience and the results published in the literature, the author analyses the current knowledge on the endoscopic treatment of vesicoureteric reflux (VUR) in children. Teflon has been the most widely used product, with more than 6,000 subureteric injections during the last 9 years over the world, and a rate of successful endoscopic correction of VUR of approximately 85%. Despite the criticisms addressed to teflon concerning its carcinogenic potential and the risk of vascular migration, neither clinical manifestations related to lung, liver or brain migrations, nor carcinogenic degeneration have been so far observed. Ureteral stenoses has been the only rare complication (< 1%), leading to secondary surgical treatment of VUR with good outcome. Persistent or recurring VUR can always be surgically treated without particular difficulties. An alternative to teflon has been looked for in recent years. The results obtained with bovine dermal collagen are presently rather disappointing due to a high rate of failure. On the contrary the preliminary results obtained with injection of microparticulate silicone appear very promising: correction of VUR in over 90% of cases and good local tolerance adding to absence of carcinogenic and migration risks. Further trials and a longer evaluation period are necessary before to consider microparticulate silicone as the ideal product to be used in the endoscopic treatment of VUR.