Single Center Experience with Endoscopic Management of Vesicoureteral Reflux in Children

Abstract

Objective - The aim of this study was to examine the results of endoscopic treatment for vesicoureteral reflux at our institution. Patients and Methods - The study was of prospective character and included 63 patients with diagnosed vesicoureteral reflux (VUR) in a total of 87 ureters. All patients underwent endoscopic treatment using the hydrodistension implantation technique (HIT) or the subureteral transurethral injection technique (STING). Patients were observed for recurrent UTI after treatment. Fifty (79.4%) patients had no recurrent UTI and 8 (12.7%) patients underwent a second endoscopic treatment and they are now free of UTI. One patient out of the 8 required a third injection. Results - The study included 63 patients with a total of 87 ureters, treated with Dx/HA copolymer. The mean age of the patients was 5.5 years (from 1 to 14 years). Fifty – one patients were female (80.1%) and 12 male (19.9%). Unilateral VUR was found in 39 and bilateral in 24 patients. Fifty-three patients (60.1%) were treated with a combination of HIT and STING procedures and 34 (39.9%) patients were treated with the STING procedure only. No more than 1 ml Dx/HA copolymer was injected into one ureteral orifice. No major complications were observed. Conclusion – The advantages of endoscopic treatment are short stay in hospital, no major complications and short operating time, in comparison to open surgery and it should be the first choice of treatment for patients with vesicoureteral reflux.