Comparative retrospective study for surgically treated primary VUR in pediatric patients

Abstract

Introduction Vesicoureteral reflux have incidence of about 1% in pediatric population. It is a very common pediatric condition. Anomalies of the ureter, the dynamics of the bladder, and the anatomy of the ureterovesical junction can lead to abnormal valve mechanisms and vesicoureteral reflux. Aim The purpose of this study is to evaluate the effectiveness of open and endoscopic urethral reimplantation in relation to the severity of the vesicoureteral reflux and renal function. Materials and Methods We retrospectively analyzed 53 children treated for primary vesicoureteral reflux at the Clinic of Pediatric Surgery in Skopje in the period from 2017 to 2020. Endoscopic treatment was done using subureteric Teflon injection “STING” technique. Operative treatment (open procedure) was used in higher grade vesicoureteral reflux (3 or 4). The evaluation of the results of the treatment was done mainly according to the following criteria: reduced grade of reflux, maintaining renal function, absence of urinary infection and postoperative complications. These outcomes were compared between the two techniques. Results and Discussion The endoscopic procedure was shown to be superior for lower grade vesicoureteral reflux. The open procedure is preferable in cases of higher vesicoureteral reflux or after failure with the endoscopic procedure. Conclusion Treatment of vesicoureteral reflux with the endoscopic procedure is always preferable due to fewer days of hospitalization and as a minimally invasive approach. Both procedures proved to be effective in reflux correction, and successfully reduce the occurrence of febrile urinary tract infections.