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Dear Sir,
Endoscopic correction of vesicoureteric reflux (VUR) is now the most common therapeutic intervention for the condition. Although much of the impetus for its use has emanated from Dublin, Ireland, there is some uncertainty about the origin of the innovation. Matouschek described the use of Teflon injected endoscopically under the ureteric ostium in 1981, in German and Spanish Journals [1, 2].
In 1984, O’Donnell and Puri, while unaware of the previous publications, described a similar technique [3, 4]. O’Donnell’s original concept of the endoscopic deposit of a bulking agent under the ureteric orifice was developed by Puri, who proposed Teflon (Polytef®) as the agent. Experimental work on piglets was carried out but none of this was done endoscopically. The agent was introduced via a porcine cystotomy.
The first endoscopic corrections of VUR in Dublin were not done on pigs but on human patients by O’Donnell, on 5 March 1984 and it was he who coined the acronym STING (Subureteric Teflon INGection). A series of successful clinical interventions followed and were reported in English [4].
We, the undersigned, were, with O’Donnell, the only three consultant paediatric surgeons on the staff of Our Lady’s Hospital for Sick Children, Dublin, at the time of the development of the procedure. Guiney was also the Professor and Director of the Children’s Research Centre. We are pleased to place on record our memory of the sequence of thoughts and events, which resulted in the evolution of this important technique.
Yours sincerely
References
Matouschek E (1981) Die behandlung des vesikorenalen refluxes durch transurethrale einspritzung von teflonpast. Urologe 20:263–264
Matouschek E (1981) Sobre un nuevo concepto para el tratamiento del reflujo vesicoureteral. Aplicacion endoscopica de Teflon. Arch Esp Urol 34(5):385–388
Puri P, O’Donnell B (1984) Correction of experimentally produced vesicoureteric reflux in the piglet by the intra-vesical injection of Teflon. Br Med J 89:5–7
O’Donnell B, Puri P (1984) Treatment of vesicoureteric reflux in the piglet by intravesical injection of Teflon. Br Med J 89:7–9
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Guiney, E.J., Fitzgerald, R.J. The early history of endoscopic correction of vesicoureteric reflux: the Dublin contribution. Ir J Med Sci 179, 163 (2010). https://doi.org/10.1007/s11845-009-0375-8
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DOI: https://doi.org/10.1007/s11845-009-0375-8