Advances in Urology / 2012 / Article / Fig 4

Methodology Report

Computer-Enhanced Visual Learning Method to Teach Endoscopic Correction of Vesicoureteral Reflux: An Invitation to Residency Training Programs to Utilize the CEVL Method

Figure 4

Procedure as CEVL components in a case of grade IV reflux in an infant girl. (a) Distal tunnel injection sequence. Injection site is judged as the halfway mark between ureter orifice (blue ring) and last injection in the background (translucent overlay). (b) Needle tip (left overlay) has penetrated mucosa and ready to inject implant. Orifice margin is noted (left overlay). (c) injection is completed as the mound of bulking implant (right overlay) obscures the lumen. The margin of the ureteral orifice is further elevated above the bladder surface (blue overlay) as shown by the graduated rule. This component is complete as the lumen beyond injection site is no longer evident and there is no evidence of HD.

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