Related Experiment Video

Updated: Jul 20, 2026

Vessel-sparing Excision and Primary Anastomosis
08:09

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

Endoscopic treatment for high grade vesicoureteral reflux in infants

Michael J Dawrant1, Nochiparambil Mohanan, Prem Puri

  • 1National Children's Hospital, and Children's Research Centre, Our Lady's Hospital for Sick Children, Crumlin, Dublin 2, Ireland.

The Journal of Urology
|September 2, 2006
PubMed

Insights

Endoscopic treatment effectively resolves high-grade vesicoureteral reflux in infants, offering a safe alternative to antibiotics and surgery. This minimally invasive approach shows long-term success in preventing kidney damage.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Pediatric Nephrology

Background:

  • Vesicoureteral reflux (VUR) in children often necessitates long-term antibiotic prophylaxis or surgical intervention.
  • Minimally invasive endoscopic treatment has emerged as a viable alternative for managing VUR.
  • Assessing the long-term outcomes of endoscopic VUR treatment in infants is crucial.

Purpose of the Study:

  • To evaluate the long-term efficacy and safety of minimally invasive endoscopic treatment for high-grade vesicoureteral reflux (VUR) in infants.
  • To compare the success rates of different tissue augmenting substances used in endoscopic VUR correction.
  • To determine the incidence of renal scarring and need for further intervention after endoscopic VUR treatment.

Main Methods:

  • Retrospective review of 411 infants with grade III-V VUR treated endoscopically between 1985 and 2004.
  • Analysis of 382 infants with 642 refluxing units, utilizing polytetrafluoroethylene (PTFE) or dextranomer/hyaluronic acid copolymer (DHAC) for injection.
  • Follow-up duration averaged 7 years, with dimercapto-succinic acid (DMSA) scans to assess renal scarring.

Main Results:

  • Complete resolution of VUR after a single endoscopic injection was achieved in 69% of ureters (73% with DHAC, 65% with PTFE).
  • 20% of ureters required repeat injections, while 10% were downgraded or required open surgery.
  • Renal scarring was present in 28% of infants prior to treatment.

Conclusions:

  • Endoscopic correction of high-grade VUR in infants is a safe and effective minimally invasive outpatient procedure.
  • Early correction of VUR via endoscopy may prevent reflux-associated renal damage.
  • This approach reduces the need for prolonged antibiotic use in pediatric patients.
Abstract

Related Concept Videos

Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Urinary Tract Calculi VI: Surgical Management01:25

Urinary Tract Calculi VI: Surgical Management

Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
Urinary Tract Calculi III: Medical Management01:30

Urinary Tract Calculi III: Medical Management

The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
Urologic Endoscopic Procedure: Cystoscopic Examination01:28

Urologic Endoscopic Procedure: Cystoscopic Examination

Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...