Endoscopic treatment of reflux: management pros and cons

The goal of this review is to contrast the issues in favor of and against the use of endoscopic injection therapy in an attempt to highlight the current state of flux and draw attention to areas that merit further research.

Current publications have mostly addressed the expanding use of endoscopic injection therapy for vesicoureteral reflux treatment, generally reporting short-term success rates and endpoints. This growing body of literature is presented in the context of perceived benefits vs. disadvantages in comparison with other available treatment modalities.

The management of vesicoureteral reflux has changed dramatically in the past decade, mostly because of the increasing acceptance of endoscopic injection therapy as an adequate, minimally invasive, and effective form of therapy. Recent advances in the composition of injectable materials have allowed for easier placement with a perceived favorable safety profile. In particular, dextranomer/hyaluronic acid has become the injectable material of choice, with quick acceptance and widespread use soon after its introduction in different countries. As we critically evaluate the evolving treatment options, the presented literature helps draw attention to some of the challenges we face and the need for long-term and carefully planned prospective studies to support our interventions.