Related Experiment Video
Updated: Aug 21, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
[Possibilities of endoscopic treatment of primary vesicoureteral reflux]
Jan Varga1, Dragana Zivković, Dusanka Dobanovaćki
1Institut za zdravstvenu zastitu dece i omladine, Klinika za decju hirurgiju, Medicinski fakultet, Novi Sad. dechirns@eunet.yu
Insights
Endoscopic correction effectively treats primary vesicoureteral reflux (VUR) in children, with high success rates after one or two applications. This minimally invasive procedure offers a safe alternative to surgery for many VUR cases.
Area of Science:
- Pediatric Urology
- Nephrology
- Minimally Invasive Surgery
Context:
- Vesicoureteral reflux (VUR) is a significant risk factor for recurrent urinary tract infections and pyelonephritic scarring in children, potentially leading to reflux nephropathy.
- Traditional management includes conservative measures and surgical intervention, but endoscopic correction has emerged as a viable therapeutic option.
Purpose:
- To evaluate the efficacy and outcomes of endoscopic correction for primary vesicoureteral reflux in pediatric patients.
- To determine the success rates of single and multiple applications of teflon paste for VUR treatment.
Summary:
- Endoscopic correction of primary VUR using teflon paste achieved a success rate of up to 93.5% over a 9-year study period.
- Complete resolution of VUR was observed in 58.8% after one application and 86.0% after two applications, with diminishing returns thereafter.
- Spontaneous regression of reflux occurred in 7.5% of treated ureters, highlighting the varied natural history of VUR.
Impact:
- Endoscopic VUR treatment is a safe, simple, and fast procedure that effectively prevents urine regurgitation into the upper urinary tract in the majority of cases.
- The findings support endoscopic correction as a primary treatment for third-grade VUR and selected cases of second and fourth-grade VUR, while guiding conservative and surgical approaches for other grades.
Introduction:
Vesicoureteral reflux, urinary infection and pyelonephritic scarring represent a well known triad in pediatric practice that may lead to severe scarring of kidneys, and development of so called reflux nephropathy. Apart from standard therapeutic options (conservative treatment and surgical therapy), endoscopic correction of refluxing vesicoureteral junction has been introduced into clinical practice.
Material And Methods:
This study included endoscopically treated patients with primary vesicoureteral reflux over a 9-year period, as well as certain clinical parameters.
Results:
Endoscopic correction of primary vesicoureteral reflux with teflon paste has been successful in up to 93.5% of patients. After one application vesicoureteral reflux disappeared in 58.8% of cases. After two applications 86.0% of ureters were cured, whereas the third application had no further effect on existing reflux. Improvement with spontaneous regression of reflux was established in 7.5% of treated ureters.
Discussion:
Endoscopic correction should be performed in all patients with third grade vesicoureteral reflux, and in selected patients with second and fourth grade reflux. First grade reflux should be treated conservatively, and fifth grade reflux should be treated surgically.
Conclusion:
Endoscopic treatment of primary vesicoureteral reflux is an easy, simple, fast and safe procedure that prevents regurgitation of urine from bladder to upper parts of the urinary system in most of cases.
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