Subureteric Transurethral INjection (STING) of polytetrafluoroethylene (Polytef) paste to treat Vesicoureteral reflux (VUR) in children was introduced in the early 1980's. Prior to this, ureteric reimplantation was the surgical treatment of choice for VUR [1]. The STING procedure was first introduced by Matouschek and was later popularised by O'Donnell and Puri in Ireland [2]. In this surgery, Polytef paste was injected beside the ureteric orifice, slightly occluding it and preventing reflux. STING surgery became a popular choice, as it was effective, had a short recovery time, minimal complications and reduced morbidity for the patients.

Polytef paste is afluoropolymer and small particle and is widely known by the brand name Teflon®. Polytef had been used for decades and was a popular bulking agent in the 1980's [3]. However, Polytef would soon fall out of favour, because it is non-biodegradable and carries a granuloma formation risk. Also, it can be phagocytosed, resulting in distant migration to the brain, lungs, and lymph nodes [4,5].

The extreme long term (>30 years) consequences of paediatric STING surgery with Polytef is unknown. However, we have seen a number of cases of Polytef granuloma of the bladder, some of which have required major surgery. We present a series of 6 patients who had the STING procedure during childhood and presented with an inflammatory giant-cell foreign-body reaction to Polytef in the bladder, some with ureteric obstruction. It is the goal of this paper to provide a source of information to urologists who encounter this condition.