Open versus endoscopic surgery in the treatment of vesicoureteral reflux

Surgical reimplantation of the ureters was compared to subureteral injection of polytetrafluoroethylene (Polytef) in the treatment of primary vesicoureteral reflux. Reflux was eliminated successfully in 98 per cent of the 76 ureters treated by reimplantation and in 70 per cent of the 40 ureters treated endoscopically. Although the surgical morbidity of endoscopic surgery appears to be less than that of open surgery, the patients undergoing endoscopic surgery required more hospital admissions, more anesthetics and more micturating cystourethrograms than did those in the reimplantation group. It is concluded that subureteral polytetrafluoroethylene injection does not represent a satisfactory substitute for reimplantation.