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Surgical management of vesicoureteral reflux in children

Jennifer Sung1, Steven Skoog

  • 1Surgery, OHSU, 3303 SW Bond Ave Mail code CH10U, Portland, OR 97239, USA.

Pediatric Nephrology (Berlin, Germany)
|June 23, 2011
PubMed

Insights

Vesicoureteral reflux (VUR) in children can lead to kidney infections and damage. While both open and endoscopic surgeries are effective, endoscopic VUR correction shows variable long-term outcomes requiring further study.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Surgical Innovation

Background:

  • Vesicoureteral reflux (VUR) is a common pediatric uropathy associated with increased risk of pyelonephritis and renal scarring after urinary tract infections (UTIs).
  • Treatment options range from observation to surgical correction, with surgery indicated for persistent reflux, renal scarring, or recurrent febrile UTIs.

Purpose of the Study:

  • To evaluate the comparative success rates and long-term outcomes of open versus endoscopic surgical correction for VUR.
  • To identify factors influencing the success of endoscopic VUR treatment.

Main Methods:

  • Comparative analysis of surgical outcomes for open and endoscopic VUR correction procedures.
  • Review of studies assessing long-term sequelae, including recurrent UTIs, renal damage, and VUR recurrence after endoscopic treatment.

Main Results:

  • Both open and endoscopic VUR correction effectively reduce febrile UTIs.
  • Open surgery demonstrates higher success rates (98.1%) compared to endoscopic methods (83.0%).
  • Endoscopic VUR treatment outcomes are variable, with reported rates of recurrent febrile UTI (0-21%), new renal damage (9-12%), and recurrent reflux (17-47.6%) at 1-year follow-up.

Conclusions:

  • Surgical correction, both open and endoscopic, is successful in managing VUR and preventing febrile UTIs.
  • Endoscopic VUR correction success is influenced by pre-operative reflux grade and bladder abnormalities.
  • Standardized reporting and extended follow-up are crucial for evaluating long-term endoscopic VUR treatment outcomes.

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