Trans trigonal phenol injection; minimally invasive procedure to treat urinary incontinence скачать в хорошем качестве

Trans trigonal phenol injection; minimally invasive procedure to treat urinary incontinence

Trans-trigonal phenol injection is a minimally invasive procedure used to treat vesicoureteral reflux (VUR) in children by injecting phenol into the trigonal area of the bladder to create a bulking effect that prevents urine from flowing backward into the ureters. 🧬 What Is It? Trans-trigonal phenol injection involves delivering phenol, a neurolytic agent, into the trigone of the bladder—the triangular area between the ureteral orifices and the bladder neck. The goal is to induce fibrosis and tissue bulk, which helps correct VUR by improving the valve mechanism at the ureterovesical junction. 🧒 Indications Primarily used in pediatric urology for: Grade I–III vesicoureteral reflux Cases where antibiotic prophylaxis fails Patients not suitable for open surgery 💉 Procedure Overview Performed under general anesthesia. A cystoscope is inserted into the bladder. Phenol is injected submucosally near the ureteral orifices. The injection causes local inflammation and scarring, which narrows the ureteral opening and prevents reflux. ✅ Advantages Minimally invasive: No incisions required. Short recovery time: Often done as a day procedure. Cost-effective: Compared to open ureteral reimplantation. ⚠️ Risks and Considerations Phenol toxicity: Rare but serious if absorbed systemically. Ureteral obstruction: Due to excessive fibrosis. Recurrence of reflux: May require repeat injections or surgery. Limited long-term data: Compared to newer agents like Deflux. 🔄 Alternatives Endoscopic injection of Deflux (dextranomer/hyaluronic acid): More commonly used today due to better safety profile. Open ureteral reimplantation: Gold standard for high-grade VUR. #Bladder