Preoperative predictors for endoscopic Deflux injection therapy for vesicoureteral reflux: a single-center experience...

We conducted an analysis to identify preoperative predictors of vesicoureteral reflux (VUR) correction following endoscopic Deflux injection (EDI).

We retrospectively reviewed 109 patients with primary VUR (173 renal units) aged < 16 years who underwent EDI between 2016 and 2025. If grade II-V VUR persisted on postoperative voiding cystoureterography, injections were repeated up to two additional times. Preoperative variables included constipation, renal scarring, and VUR grade.

VUR was corrected in 86 units (49.7%) after the first injection and in 152 (87.9%) after up to three injections. Univariable analysis showed that high-grade VUR, renal scarring, and constipation were associated with failure after the first injection, whereas only constipation was associated with failure after up to three injections. Multivariable analysis identified high-grade VUR, renal scarring and constipation as independent risk factors for failure of the first injection. These associations persisted even after exclusion of clinically evident bladder and bowel dysfunction (BBD).

Constipation was an independent risk factor for failure after the first injection and remained associated with failure after repeated injections, even after exclusion of clinically evident BBD. It may serve as a clinically relevant and easily assessable predictor, particularly in young children in whom bladder function is difficult to assess.