Related Experiment Video
Updated: May 20, 2026
Treatment of Ejaculatory Duct Obstruction by Seminal Vesiculoscopy Assisted Flow Modification
Published on: December 8, 2023
[Surgical treatment of vesicourethral reflux in paediatric population]
Ana Aguiar1, André Cardoso, Rui Prisco
1Serviço de Pediatria, Hospital Pedro Hispano, Matosinhos, Portugal.
Insights
Endoscopic surgery for pediatric vesicourethral reflux has lower success rates but fewer complications than conventional surgery. This suggests endoscopic treatment may be preferable, especially in smaller centers, balancing safety and effectiveness.
Area of Science:
- Pediatric Urology
- Surgical Techniques
- Vesicourethral Reflux
Context:
- Vesicourethral reflux (VUR) in children requires early diagnosis and follow-up.
- Treatment choices for VUR are individualized based on various factors.
Purpose:
- To compare the effectiveness and safety of endoscopic versus conventional surgical treatments for VUR in pediatric patients.
Summary:
- A cohort study analyzed 46 children (68 refluxive units) treated between 2000-2006.
- Endoscopic treatment (Deflux®) showed success rates of 62% (1 injection) to 78% (2 injections).
- Conventional surgery achieved a 97% success rate, but with significantly higher complication rates (85% of 13 complications).
Impact:
- Endoscopic surgery offers a favorable safety profile, potentially justifying its use in centers with fewer resources.
- Conventional surgery demonstrates higher efficacy but carries a greater risk of complications.
- The findings support a balanced approach to VUR treatment, considering both prophylactic safety and surgical effectiveness.
Background:
Early diagnosis and adequate follow-up are fundamental principals for the treatment of vesicourethral reflux in children. The treatment options in these cases remain an individual choice based on multiple factors.
Objective:
To determine and compare the effectiveness of two different surgical techniques (endoscopic and conventional) used on vesicourethral reflux treatment.
Methodology:
Cohort study, based on the clinical files of children and adolescents submitted to surgical treatment of vesicourethral reflux, between the 1st January of 2000 and 30th April 2006. The study included one year period of follow-up. Multiple variables with a presumable influence on the therapeutic option were analysed. In cases of surgical treatment, effectiveness and safety of the surgical technique where determined.
Results:
Included 46 children and adolescents, in a total of 68 refluxive units. Thirty seven of all renal units, where submitted to endoscopic treatment: the success rate with one injection of Deflux® was 62% (IC 95% [0.46; 0.78]), increasing for 78% (IC 95% [0.65; 0.91]) when the second injection was performed. Thirty seven renal units were submitted to open surgery: Cohen procedure in 21 patients and nefrourethrectomy in two cases. Excluding the nefrourethrectomy, the classical surgery had a success rate of 97% (IC 95% [0.91; 1]). The reason between probabilities of success, considering endoscopic surgery vs. conventional surgery was 0,8 (IC 95% [0.68; 0.97]). Registered thirteen complications, most of them (85%) after conventional surgery.
Discussion:
The high complication rates determined for conventional surgery could justify the frequent option for endoscopic surgery in small centres, despite its lower success rates.
Conclusion:
This study confirms that this therapeutic option establishes a good commitment between prophylaxis safety and classical surgery effectiveness.
Related Concept Videos
01:25Urinary Tract Calculi VI: Surgical Management
01:30Urinary Tract Calculi III: Medical Management
01:22Imaging Studies V: Intravenous Urography and Retrograde Pyelography
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
01:26Kidney Transplant II: Surgical Procedure
01:28Urinary Tract Calculi V: Nursing Management